What is it about?
Whereas conventional de-escalation of antimicrobial therapy (after 4 days) has been demonstrated to be non-inferior to broad-spectrum therapy, this is the first study to report superiority of early de-escalation of therapy.
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Why is it important?
In the era of rapid diagnostics, early de-escalation of antimicrobial therapy within 48 hours has become a reality. Early de-escalation of anti-pseudomonal beta-lactams in patients with Enterobacteriaceae bloodstream infections is associated with a 3-fold decline in the risk of C. difficile infection.
Perspectives
The study carries a strong antimicrobial stewardship message. Early de-escalation of broad-spectrum therapy reduces the risk of C. difficile infection. Antimicrobial stewards making recommendations for de-escalation of antimicrobial therapy on a daily basis can use this message to improve clinicians' compliance with their recommendations. By the way, we did not invent de-escalation, just early de-escalation.
Prof. Majdi Al-Hasan
University of South Carolina School of Medicine
Read the Original
This page is a summary of: Role of Early De-escalation of Antimicrobial Therapy on Risk of Clostridioides difficile Infection Following Enterobacteriaceae Bloodstream Infections, Clinical Infectious Diseases, October 2018, Oxford University Press (OUP),
DOI: 10.1093/cid/ciy863.
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