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2. ESCMID generic competencies in antimicrobial prescribing and stewardship: towards a European consensus

Author

Ashiru-Oredope, D., Barcs, I., Blix, H.S., Buyle, F., Chowers, M., Čižman, M., Cookson, B., Del Pozo, J.L., Deptula, A., Dumpis, U., Florea, D., van de Garde, E., Geffen, Y., Giske, C.G., Grau, S., Hajdú, E., Hell, M., Hondo, Ł., Hussein, K., Huttner, B., Kern, W., Kernéis, S., Knepper, V., Kofteridis, D., Kostyanev, T., Kuijper, E., Lebanova, H., Lewis, R., Cordina, C.M., Matulionyte, R., Maurer, F., Messiaen, P., Miciuleviciene, J., Mrhar, A., Nabuurs-Franssen, M., Naesens, R., Oxacelay, C., Pagani, L., Paño-Pardo, J.R., Paul, M., Petrikkos, G., Pluess-Suard, C., Popescu, G.A., Porsche, U., Prins, J., Pulcini, C., Rello, J., Rodríguez-Baño, J., Rossolini, G.M., Salzberger, B., Seme, K., Simonsen, G.S., Sînziana, M., Skovgaard, S., Smith, I., Sönsken, U., Soriano, A., Sviestiņa, I., Szilagyi, E., Tängdén, T., Tattevin, P., Tsioutis, C., Vilde, A., Wanke-Rytt, M., Wechsler-Fördös, A., Zarb, P., Dyar, O.J., Beović, B., Tacconelli, E., and Hulscher, M.

Published
2019
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3. Antibiotic treatment of infections caused by carbapenem-resistant Gram-negative bacilli: an international ESCMID cross-sectional survey among infectious diseases specialists practicing in large hospitals

Author

Abbo, L., Abgueguen, P., Almirante, B., Azzini, A.M., Bani-Sadr, F., Bassetti, M., Ben-Ami, R., Beović, B., Béraud, G., Botelho-Nevers, E., Bou, G., Boutoille, D., Cabié, A., Cacopardo, B., Cascio, A., Cassir, N., Castelli, F., Cecala, M., Charmillon, A., Chirouze, C., Cisneros, J.M., Colmenero, J.D., Coppola, N., Corcione, S., Daikos, G.L., Dalla Gasperina, D., De la Calle Cabrera, C., Delobel, P., Di Caprio, D., Durante Mangoni, E., Dupon, M., Ettahar, N., Falagas, M.E., Falcone, M., Fariñas, M.C., Faure, E., Forestier, E., Foti, G., Gallagher, J., Gattuso, G., Gendrin, V., Gentile, I., Giacobbe, D.R., Gogos, C.A., Grandiere Perez, L., Hansmann, Y., Horcajada, J.P., Iacobello, C., Jacob, J.T., Justo, J.A., Kernéis, S., Komnos, A., Kotnik Kevorkijan, B., Lebeaux, D., Le Berre, R., Lechiche, C., Le Moxing, V., Lescure, F.X., Libanore, M., Martinot, M., Merino de Lucas, E., Mondain, V., Mondello, P., Montejo, M., Mootien, J., Muñoz, P., Nir-Paz, R., Pan, A., Paño-Pardo, J.R., Patel, G., Paul, M., Pérez Rodríguez, M.T., Piroth, L., Pogue, J., Potoski, B.A., Pourcher, V., Pyrpasopoulou, A., Rahav, G., Rizzi, M., Rodríguez-Baño, J., Salavert, M., Scheetz, M., Sims, M., Spahija, G., Stefani, S., Stefos, A., Tamma, P.D., Tattevin, P., Tedesco, A., Torre-Cisneros, J., Tripolitsioti, P., Tsiodras, S., Uomo, G., Verdon, R., Viale, P., Vitrat, V., Weinberger, M., Wiener-Well, Y., Papst, L., Pulcini, C., Durante-Mangoni, E., Kaye, K.S., and Raka, L.

Published
2018
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5. European survey on principles of prudent antibiotic prescribing teaching in undergraduate students

Author

Gyssens, I.C., Jacobs, F., Peetermans, W., Francetić, I., Vlahović-Palčevski, V., Frimodt-Mǿller, N., Høiby, N., Kilian, M., Ader, F., Cazorla, C., Etienne, M., Pulcini, C., Fätkenheuer, G., Kern, W.V., Pletz, M.W., Salzberger, B., Cacopardo, B., Mikulska, M., Mussini, C., Orlando, G., Stefani, S., Lowe, S.H., Nouwen, J.L., Afset, J.E., Bergh, K., Müller, F., Simonsen, G.S., Carevic, B., Horvat, O., Jankovic, S., Beović, B., Gorisek, J.R., Canton, R., Fariñas, M.C., Gudiol, F., Paño Pardo, J.R., Rodríguez Baño, J., Harbarth, S., Zanetti, G., Barlow, G., Brown, N., Healy, B., Nathwani, D., Wencker, F., Frimodt-Møller, N., and Rodríguez-Baño, J.

Published
2015
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6. The microbiological diagnosis of tuberculous meningitis of Haydarpasa-1 study

Author

Erdem, H., Ozturk-Engin, D., Elaldi, N., Gulsun, S., Sengoz, G., Crisan, A., Johansen, I.S., Inan, A., Nechifor, M., Al-Mahdawi, A., Civljak, R., Ozguler, M., Savic, B., Ceran, N., Cacopardo, B., Inal, A.S., Namiduru, M., Dayan, S., Kayabas, U., Parlak, E., Khalifa, A., Kursun, E., Sipahi, O.R., Yemisen, M., Akbulut, A., Bitirgen, M., Dulovic, O., Kandemir, B., Luca, C., Parlak, M., Stahl, J.P., Pehlivanoglu, F., Simeon, S., Ulu-Kilic, A., Yasar, K., Yilmaz, G., Yilmaz, E., Beovic, B., Catroux, M., Lakatos, B., Sunbul, M., Oncul, O., Alabay, S., Sahin-Horasan, E., Kose, S., Shehata, G., Andre, K., Alp, A., Ćosic, G., Gul, H. Cem, Karakas, A., Chadapaud, S., Hansmann, Y., Harxhi, A., Kirova, V., Masse-Chabredier, I., Oncu, S., Sener, A., Tekin, R., Deveci, O., Karabay, O., and Agalar, C.

Published
2014
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7. Duration of Treatment for Pseudomonas aeruginosa Bacteremia: a Retrospective Study

Author

Babich, T., Naucler, P., Valik, J.K., Giske, C.G., Benito, Natividad, Cardona, R., Rivera, Alba, Pulcini, C., Fattah, M.A., Haquin, J., Macgowan, A., Grier, S., Chazan, B., Yanovskay, A., Ami, R.B., Landes, M., Nesher, L., Zaidman-Shimshovitz, A., McCarthy, K., Paterson, D.L., Tacconelli, E., Buhl, M., Mauer, S., Rodríguez-Baño, J., de Cueto, M., Oliver, A., de Gopegui, E.R., Cano, A., Machuca, I., Gozalo-Marguello, M., Martinez-Martinez, L., Gonzalez-Barbera, E.M., Alfaro, I.G., Salavert, M., Beovic, B., Saje, A., Mueller-Premru, M., Pagani, L., Vitrat, V., Kofteridis, D., Zacharioudaki, M., Maraki, S., Weissman, Y., Paul, M., Dickstein, Y., Leibovici, L., Yahav, D., Universitat Autònoma de Barcelona, and Yahav, Dafna

Subjects
Microbiology (medical), Infectious Diseases, Duration, Antibiotics, Pseudomonas aeruginosa, Bacteremia, Antimicrobial stewardship
Abstract

[Introduction] There is no consensus regarding optimal duration of antibiotic therapy for Pseudomonas aeruginosa bacteremia. We aimed to evaluate the impact of short antibiotic course., [Methods] We present a retrospective multicenter study including patients with P. aeruginosa bacteremia during 2009–2015. We evaluated outcomes of patients treated with short (6–10 days) versus long (11–15 days) antibiotic courses. The primary outcome was a composite of 30-day mortality or bacteremia recurrence and/or persistence. Univariate and inverse probability treatment-weighted (IPTW) adjusted multivariate analysis for the primary outcome was performed. To avoid immortal time bias, the landmark method was used., [Results] We included 657 patients; 273 received a short antibiotic course and 384 a long course. There was no significant difference in baseline characteristics of patients. The composite primary outcome occurred in 61/384 patients in the long-treatment group (16%) versus 32/273 in the short-treatment group (12%) (p = 0.131). Mortality accounted for 41/384 (11%) versus 25/273 (9%) of cases, respectively. Length of hospital stay was significantly shorter in the short group [median 13 days, interquartile range (IQR) 9–21 days, versus median 15 days, IQR 11–26 days, p = 0.002]. Ten patients in the long group discontinued antibiotic therapy owing to adverse events, compared with none in the short group. On univariate and multivariate analyses, duration of therapy was not associated with the primary outcome., [Conclusions] In this retrospective study, 6–10 days of antibiotic course for P. aeruginosa bacteremia were as effective as longer courses in terms of survival and recurrence. Shorter therapy was associated with reduced length of stay and less drug discontinuation.

Published
2022

9. The microbiological diagnosis of tuberculous meningitis: results of Haydarpasa-1 study

Author

Erdem, H., Ozturk-Engin, D., Elaldi, N., Gulsun, S., Sengoz, G., Crisan, A., Johansen, I. S., Inan, A., Nechifor, M., Al-Mahdawi, A., Civljak, R., Ozguler, M., Savic, B., Ceran, N., Cacopardo, B., Inal, A. S., Namiduru, M., Dayan, S., Kayabas, U., Parlak, E., Khalifa, A., Kursun, E., Sipahi, O. R., Yemisen, M., Akbulut, A., Bitirgen, M., Dulovic, O., Kandemir, B., Luca, C., Parlak, M., Stahl, J. P., Pehlivanoglu, F., Simeon, S., Ulu-Kilic, A., Yasar, K., Yilmaz, G., Yilmaz, E., Beovic, B., Catroux, M., Lakatos, B., Sunbul, M., Oncul, O., Alabay, S., Sahin-Horasan, E., Kose, S., Shehata, G., Andre, K., Alp, A., Ćosić, G., Cem Gul, H., Karakas, A., Chadapaud, S., Hansmann, Y., Harxhi, A., Kirova, V., Masse-Chabredier, I., Oncu, S., Sener, A., Tekin, R., Deveci, O., Karabay, O., Agalar, C., and Allerberger, F.

Published
2014
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10. Antimicrobial de-escalation as part of antimicrobial stewardship in intensive care: no simple answers to simple questions-a viewpoint of experts

Author

Waele, J.J. De, Schouten, J.A., Beovic, B., Tabah, A., Leone, M., Waele, J.J. De, Schouten, J.A., Beovic, B., Tabah, A., and Leone, M.

Abstract

Contains fulltext : 218605.pdf (Publisher’s version ) (Closed access), Antimicrobial de-escalation (ADE) is defined as the discontinuation of one or more components of combination empirical therapy, and/or the change from a broad-spectrum to a narrower spectrum antimicrobial. It is most commonly recommended in the intensive care unit (ICU) patient who is treated with broad-spectrum antibiotics as a strategy to reduce antimicrobial pressure of empirical broad-spectrum therapy and prevent antimicrobial resistance, yet this has not been convincingly demonstrated in a clinical setting. Even if it appears beneficial, ADE may have some unwanted side effects: it has been associated with prolongation of antimicrobial therapy and could inappropriately be used as a justification for unrestricted broadness of empirical therapy. Also, exposing a patient to multiple, sequential antimicrobials could have unwanted effects on the microbiome. For these reasons, ADE has important shortcomings to be promoted as a quality indicator for appropriate antimicrobial use in the ICU. Despite this, ADE clearly has a role in the management of infections in the ICU. The most appropriate use of ADE is in patients with microbiologically confirmed infections requiring longer antimicrobial therapy. ADE should be used as an integral part of an ICU antimicrobial stewardship approach in which it is guided by optimal specimen quality and relevance. Rapid diagnostics may further assist in avoiding unnecessary initiation of broad-spectrum therapy, which in turn will decrease the need for subsequent ADE.

Published
2020

11. Neuraminidase Inhibitors and Hospital Length of Stay: A Meta-analysis of Individual Participant Data to Determine Treatment Effectiveness Among Patients Hospitalized With Nonfatal 2009 Pandemic Influenza A(H1N1) Virus Infection

Author

Venkatesan, S, Myles, PR, Bolton, KJ, Muthuri, SG, Al Khuwaitir, T, Anovadiya, AP, Azziz-Baumgartner, E, Bajjou, T, Bassetti, M, Beovic, B, Bertisch, B, Bonmarin, I, Booy, R, Borja-Aburto, VH, Burgmann, H, Cao, B, Carratala, J, Chinbayar, T, Cilloniz, C, Denholm, JT, Dominguez, SR, Duarte, PAD, Dubnov-Raz, G, Fanella, S, Gao, Z, Gerardin, P, Giannella, M, Gubbels, S, Herberg, J, Higuera Iglesias, AL, Hoeger, PH, Hu, XY, Islam, QT, Jimenez, MF, Keijzers, G, Khalili, H, Kusznierz, G, Kuzman, I, Langenegger, E, Lankarani, KB, Leo, Y-S, Libster, RP, Linko, R, Madanat, F, Maltezos, E, Mamun, A, Manabe, T, Metan, G, Mickiene, A, Mikic, D, Mohn, KG, Oliva, ME, Ozkan, M, Parekh, D, Paul, M, Rath, BA, Refaey, S, Rodriguez, AH, Sertogullarindan, B, Skret-Magierlo, J, Somer, A, Talarek, E, Tang, JW, To, K, Dat, T, Uyeki, TM, Vaudry, W, Vidmar, T, Zarogoulidis, P, Nguyen-Van-Tam, JS, Venkatesan, S, Myles, PR, Bolton, KJ, Muthuri, SG, Al Khuwaitir, T, Anovadiya, AP, Azziz-Baumgartner, E, Bajjou, T, Bassetti, M, Beovic, B, Bertisch, B, Bonmarin, I, Booy, R, Borja-Aburto, VH, Burgmann, H, Cao, B, Carratala, J, Chinbayar, T, Cilloniz, C, Denholm, JT, Dominguez, SR, Duarte, PAD, Dubnov-Raz, G, Fanella, S, Gao, Z, Gerardin, P, Giannella, M, Gubbels, S, Herberg, J, Higuera Iglesias, AL, Hoeger, PH, Hu, XY, Islam, QT, Jimenez, MF, Keijzers, G, Khalili, H, Kusznierz, G, Kuzman, I, Langenegger, E, Lankarani, KB, Leo, Y-S, Libster, RP, Linko, R, Madanat, F, Maltezos, E, Mamun, A, Manabe, T, Metan, G, Mickiene, A, Mikic, D, Mohn, KG, Oliva, ME, Ozkan, M, Parekh, D, Paul, M, Rath, BA, Refaey, S, Rodriguez, AH, Sertogullarindan, B, Skret-Magierlo, J, Somer, A, Talarek, E, Tang, JW, To, K, Dat, T, Uyeki, TM, Vaudry, W, Vidmar, T, Zarogoulidis, P, and Nguyen-Van-Tam, JS

Abstract

BACKGROUND: The effect of neuraminidase inhibitor (NAI) treatment on length of stay (LoS) in patients hospitalized with influenza is unclear. METHODS: We conducted a one-stage individual participant data (IPD) meta-analysis exploring the association between NAI treatment and LoS in patients hospitalized with 2009 influenza A(H1N1) virus (A[H1N1]pdm09) infection. Using mixed-effects negative binomial regression and adjusting for the propensity to receive NAI, antibiotic, and corticosteroid treatment, we calculated incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Patients with a LoS of <1 day and those who died while hospitalized were excluded. RESULTS: We analyzed data on 18 309 patients from 70 clinical centers. After adjustment, NAI treatment initiated at hospitalization was associated with a 19% reduction in the LoS among patients with clinically suspected or laboratory-confirmed influenza A(H1N1)pdm09 infection (IRR, 0.81; 95% CI, .78-.85), compared with later or no initiation of NAI treatment. Similar statistically significant associations were seen in all clinical subgroups. NAI treatment (at any time), compared with no NAI treatment, and NAI treatment initiated <2 days after symptom onset, compared with later or no initiation of NAI treatment, showed mixed patterns of association with the LoS. CONCLUSIONS: When patients hospitalized with influenza are treated with NAIs, treatment initiated on admission, regardless of time since symptom onset, is associated with a reduced LoS, compared with later or no initiation of treatment.

Published
2020

12. A Global Declaration on Appropriate Use of Antimicrobial Agents across the Surgical Pathway

Author

Sartelli, M, Kluger, Y, Ansaloni, L, Carlet, J, Brink, A, Hardcastle, T, Khanna, A, Chicom-Mefire, A, Rodriguez-Bano, J, Nathwani, D, Mendelson, M, Watkins, R, Pulcini, C, Beovic, B, May, A, Itani, K, Mazuski, J, Fry, D, Coccolini, F, Rasxa, K, Montravers, P, Eckmann, C, Abbo, L, Abubakar, S, Abu-Zidan, F, Adesunkanmi, A, Al-Hasan, M, Althani, A, Ticas, J, Ansari, S, Ansumana, R, Da Silva, A, Augustin, G, Bala, M, Balogh, Z, Baraket, O, Bassetti, M, Bellanova, G, Beltran, M, Ben-Ishay, O, Biffl, W, Boermeester, M, Brecher, S, Bueno, J, Cainzos, M, Cairns, K, Camacho-Ortiz, A, Ceresoli, M, Chandy, S, Cherry-Bukowiec, J, Cirocchi, R, Colak, E, Corcione, A, Cornely, O, Cortese, F, Cui, Y, Curcio, D, Damaskos, D, Dasx, K, Delibegovic, S, Demetrashvili, Z, De Simone, B, De Souza, H, De Waele, J, Dhingra, S, Diaz, J, Di Carlo, I, Di Marzo, F, Di Saverio, S, Dogjani, A, Dorj, G, Dortet, L, Duane, T, Dupont, H, Egiev, V, Eid, H, Elmangory, M, El-Sayed Marei, H, Enani, M, Escandon-Vargas, K, Faro, M, Ferrada, P, Foghetti, D, Foianini, E, Fraga, G, Frattima, S, Gandhi, C, Gattuso, G, Giamarellou, E, Ghnnam, W, Gkiokas, G, Girardis, M, Goff, D, Gomes, C, Gomi, H, Gronerth, R, Guirao, X, Guzman-Blanco, M, Haque, M, Hecker, A, Hell, M, Herzog, T, Hicks, L, Kafka-Ritsch, R, Kao, L, Kanj, S, Kaplan, L, Kapoor, G, Karamarkovic, A, Kashuk, J, Kenig, J, Khamis, F, Khokha, V, Kiguba, R, Kirkpatrick, A, Korner, H, Koike, K, Kok, K, Kon, K, Kong, V, Inaba, K, Ioannidis, O, Isik, A, Iskandar, K, Labbate, M, Labricciosa, F, Lagrou, K, Lagunes, L, Latifi, R, Lasithiotakis, K, Laxminarayan, R, Lee, J, Leone, M, Leppaniemi, A, Li, Y, Liang, S, Liau, K, Litvin, A, Loho, T, Lowman, W, Machain, G, Maier, R, Manzano-Nunez, R, Marinis, A, Marmorale, C, Martin-Loeches, I, Marwah, S, Maseda, E, Mcfarlane, M, De Melo, R, Melotti, M, Memish, Z, Mertz, D, Mesina, C, Menichetti, F, Mishra, S, Montori, G, Moore, E, Moore, F, Naidoo, N, Napolitano, L, Negoi, I, Nicolau, D, Nikolopoulos, I, Nord, C, Ofori-Asenso, R, Olaoye, I, Omari, A, Ordonez, C, Ouadii, M, Ouedraogo, A, Pagani, L, Paiva, J, Parreira, J, Pata, F, Pereira, J, Pereira, N, Petrosillo, N, Picetti, E, Pintar, T, Ponce-De-Leon, A, Popovski, Z, Poulakou, G, Preller, J, Guerrero, A, Pupelis, G, Quiodettis, M, Rawson, T, Reichert, M, Reinhart, K, Rems, M, Rello, J, Rizoli, S, Roberts, J, Rubio-Perez, I, Ruppe, E, Sakakushev, B, Sall, I, Kafil, H, Sanders, J, Sato, N, Sawyer, R, Scalea, T, Scibe, R, Scudeller, L, Lohse, H, Sganga, G, Shafiq, N, Shah, J, Spigaglia, P, Suroowan, S, Tsioutis, C, Sifri, C, Siribumrungwong, B, Sugrue, M, Talving, P, Tan, B, Tarasconi, A, Tascini, C, Tilsed, J, Timsit, J, Tumbarello, M, Trung, N, Ulrych, J, Uranues, S, Velmahos, G, Vereczkei, A, Viale, P, Estape, J, Viscoli, C, Wagenlehner, F, Wright, B, Xiao, Y, Yuan, K, Zachariah, S, Zahar, J, Mergulhao, P, Catena, F, Sartelli M., Kluger Y., Ansaloni L., Carlet J., Brink A., Hardcastle T. C., Khanna A., Chicom-Mefire A., Rodriguez-Bano J., Nathwani D., Mendelson M., Watkins R. R., Pulcini C., Beovic B., May A. K., Itani K. M. F., Mazuski J. E., Fry D. E., Coccolini F., Rasxa K., Montravers P., Eckmann C., Abbo L. M., Abubakar S., Abu-Zidan F. M., Adesunkanmi A. K., Al-Hasan M. N., Althani A. A., Ticas J. E. A., Ansari S., Ansumana R., Da Silva A. R. A., Augustin G., Bala M., Balogh Z. J., Baraket O., Bassetti M., Bellanova G., Beltran M. A., Ben-Ishay O., Biffl W. L., Boermeester M. A., Brecher S. M., Bueno J., Cainzos M. A., Cairns K., Camacho-Ortiz A., Ceresoli M., Chandy S. J., Cherry-Bukowiec J. R., Cirocchi R., Colak E., Corcione A., Cornely O. A., Cortese F., Cui Y., Curcio D., Damaskos D., Dasx K., Delibegovic S., Demetrashvili Z., De Simone B., De Souza H. P., De Waele J., Dhingra S., Diaz J. J., Di Carlo I., Di Marzo F., Di Saverio S., Dogjani A., Dorj G., Dortet L., Duane T. M., Dupont H., Egiev V. N., Eid H. O., Elmangory M., El-Sayed Marei H., Enani M. A., Escandon-Vargas K., Faro M. P., Ferrada P., Foghetti D., Foianini E., Fraga G. P., Frattima S., Gandhi C., Gattuso G., Giamarellou E., Ghnnam W., Gkiokas G., Girardis M., Goff D. A., Gomes C. A., Gomi H., Gronerth R. I. G., Guirao X., Guzman-Blanco M., Haque M., Hecker A., Hell M., Herzog T., Hicks L., Kafka-Ritsch R., Kao L. S., Kanj S. S., Kaplan L. J., Kapoor G., Karamarkovic A., Kashuk J., Kenig J., Khamis F., Khokha V., Kiguba R., Kirkpatrick A. W., Korner H., Koike K., Kok K. Y. Y., Kon K., Kong V., Inaba K., Ioannidis O., Isik A., Iskandar K., Labbate M., Labricciosa F. M., Lagrou K., Lagunes L., Latifi R., Lasithiotakis K., Laxminarayan R., Lee J. G., Leone M., Leppaniemi A., Li Y., Liang S. Y., Liau K. -H., Litvin A., Loho T., Lowman W., Machain G. M., Maier R. V., Manzano-Nunez R., Marinis A., Marmorale C., Martin-Loeches I., Marwah S., Maseda E., McFarlane M., De Melo R. B., Melotti M. R., Memish Z., Mertz D., Mesina C., Menichetti F., Mishra S. K., Montori G., Moore E. E., Moore F. A., Naidoo N., Napolitano L., Negoi I., Nicolau D. P., Nikolopoulos I., Nord C. E., Ofori-Asenso R., Olaoye I., Omari A. H., Ordonez C. A., Ouadii M., Ouedraogo A. -S., Pagani L., Paiva J. A., Parreira J. G., Pata F., Pereira J., Pereira N. R., Petrosillo N., Picetti E., Pintar T., Ponce-De-Leon A., Popovski Z., Poulakou G., Preller J., Guerrero A. P., Pupelis G., Quiodettis M., Rawson T. M., Reichert M., Reinhart K., Rems M., Rello J., Rizoli S., Roberts J., Rubio-Perez I., Ruppe E., Sakakushev B., Sall I., Kafil H. S., Sanders J., Sato N., Sawyer R. G., Scalea T., Scibe R., Scudeller L., Lohse H. S., Sganga G., Shafiq N., Shah J. N., Spigaglia P., Suroowan S., Tsioutis C., Sifri C. D., Siribumrungwong B., Sugrue M., Talving P., Tan B. K., Tarasconi A., Tascini C., Tilsed J., Timsit J. -F., Tumbarello M., Trung N. T., Ulrych J., Uranues S., Velmahos G., Vereczkei A. G., Viale P., Estape J. V., Viscoli C., Wagenlehner F., Wright B. J., Xiao Y., Yuan K. -C., Zachariah S. K., Zahar J. R., Mergulhao P., Catena F., Sartelli, M, Kluger, Y, Ansaloni, L, Carlet, J, Brink, A, Hardcastle, T, Khanna, A, Chicom-Mefire, A, Rodriguez-Bano, J, Nathwani, D, Mendelson, M, Watkins, R, Pulcini, C, Beovic, B, May, A, Itani, K, Mazuski, J, Fry, D, Coccolini, F, Rasxa, K, Montravers, P, Eckmann, C, Abbo, L, Abubakar, S, Abu-Zidan, F, Adesunkanmi, A, Al-Hasan, M, Althani, A, Ticas, J, Ansari, S, Ansumana, R, Da Silva, A, Augustin, G, Bala, M, Balogh, Z, Baraket, O, Bassetti, M, Bellanova, G, Beltran, M, Ben-Ishay, O, Biffl, W, Boermeester, M, Brecher, S, Bueno, J, Cainzos, M, Cairns, K, Camacho-Ortiz, A, Ceresoli, M, Chandy, S, Cherry-Bukowiec, J, Cirocchi, R, Colak, E, Corcione, A, Cornely, O, Cortese, F, Cui, Y, Curcio, D, Damaskos, D, Dasx, K, Delibegovic, S, Demetrashvili, Z, De Simone, B, De Souza, H, De Waele, J, Dhingra, S, Diaz, J, Di Carlo, I, Di Marzo, F, Di Saverio, S, Dogjani, A, Dorj, G, Dortet, L, Duane, T, Dupont, H, Egiev, V, Eid, H, Elmangory, M, El-Sayed Marei, H, Enani, M, Escandon-Vargas, K, Faro, M, Ferrada, P, Foghetti, D, Foianini, E, Fraga, G, Frattima, S, Gandhi, C, Gattuso, G, Giamarellou, E, Ghnnam, W, Gkiokas, G, Girardis, M, Goff, D, Gomes, C, Gomi, H, Gronerth, R, Guirao, X, Guzman-Blanco, M, Haque, M, Hecker, A, Hell, M, Herzog, T, Hicks, L, Kafka-Ritsch, R, Kao, L, Kanj, S, Kaplan, L, Kapoor, G, Karamarkovic, A, Kashuk, J, Kenig, J, Khamis, F, Khokha, V, Kiguba, R, Kirkpatrick, A, Korner, H, Koike, K, Kok, K, Kon, K, Kong, V, Inaba, K, Ioannidis, O, Isik, A, Iskandar, K, Labbate, M, Labricciosa, F, Lagrou, K, Lagunes, L, Latifi, R, Lasithiotakis, K, Laxminarayan, R, Lee, J, Leone, M, Leppaniemi, A, Li, Y, Liang, S, Liau, K, Litvin, A, Loho, T, Lowman, W, Machain, G, Maier, R, Manzano-Nunez, R, Marinis, A, Marmorale, C, Martin-Loeches, I, Marwah, S, Maseda, E, Mcfarlane, M, De Melo, R, Melotti, M, Memish, Z, Mertz, D, Mesina, C, Menichetti, F, Mishra, S, Montori, G, Moore, E, Moore, F, Naidoo, N, Napolitano, L, Negoi, I, Nicolau, D, Nikolopoulos, I, Nord, C, Ofori-Asenso, R, Olaoye, I, Omari, A, Ordonez, C, Ouadii, M, Ouedraogo, A, Pagani, L, Paiva, J, Parreira, J, Pata, F, Pereira, J, Pereira, N, Petrosillo, N, Picetti, E, Pintar, T, Ponce-De-Leon, A, Popovski, Z, Poulakou, G, Preller, J, Guerrero, A, Pupelis, G, Quiodettis, M, Rawson, T, Reichert, M, Reinhart, K, Rems, M, Rello, J, Rizoli, S, Roberts, J, Rubio-Perez, I, Ruppe, E, Sakakushev, B, Sall, I, Kafil, H, Sanders, J, Sato, N, Sawyer, R, Scalea, T, Scibe, R, Scudeller, L, Lohse, H, Sganga, G, Shafiq, N, Shah, J, Spigaglia, P, Suroowan, S, Tsioutis, C, Sifri, C, Siribumrungwong, B, Sugrue, M, Talving, P, Tan, B, Tarasconi, A, Tascini, C, Tilsed, J, Timsit, J, Tumbarello, M, Trung, N, Ulrych, J, Uranues, S, Velmahos, G, Vereczkei, A, Viale, P, Estape, J, Viscoli, C, Wagenlehner, F, Wright, B, Xiao, Y, Yuan, K, Zachariah, S, Zahar, J, Mergulhao, P, Catena, F, Sartelli M., Kluger Y., Ansaloni L., Carlet J., Brink A., Hardcastle T. C., Khanna A., Chicom-Mefire A., Rodriguez-Bano J., Nathwani D., Mendelson M., Watkins R. R., Pulcini C., Beovic B., May A. K., Itani K. M. F., Mazuski J. E., Fry D. E., Coccolini F., Rasxa K., Montravers P., Eckmann C., Abbo L. M., Abubakar S., Abu-Zidan F. M., Adesunkanmi A. K., Al-Hasan M. N., Althani A. A., Ticas J. E. A., Ansari S., Ansumana R., Da Silva A. R. A., Augustin G., Bala M., Balogh Z. J., Baraket O., Bassetti M., Bellanova G., Beltran M. A., Ben-Ishay O., Biffl W. L., Boermeester M. A., Brecher S. M., Bueno J., Cainzos M. A., Cairns K., Camacho-Ortiz A., Ceresoli M., Chandy S. J., Cherry-Bukowiec J. R., Cirocchi R., Colak E., Corcione A., Cornely O. A., Cortese F., Cui Y., Curcio D., Damaskos D., Dasx K., Delibegovic S., Demetrashvili Z., De Simone B., De Souza H. P., De Waele J., Dhingra S., Diaz J. J., Di Carlo I., Di Marzo F., Di Saverio S., Dogjani A., Dorj G., Dortet L., Duane T. M., Dupont H., Egiev V. N., Eid H. O., Elmangory M., El-Sayed Marei H., Enani M. A., Escandon-Vargas K., Faro M. P., Ferrada P., Foghetti D., Foianini E., Fraga G. P., Frattima S., Gandhi C., Gattuso G., Giamarellou E., Ghnnam W., Gkiokas G., Girardis M., Goff D. A., Gomes C. A., Gomi H., Gronerth R. I. G., Guirao X., Guzman-Blanco M., Haque M., Hecker A., Hell M., Herzog T., Hicks L., Kafka-Ritsch R., Kao L. S., Kanj S. S., Kaplan L. J., Kapoor G., Karamarkovic A., Kashuk J., Kenig J., Khamis F., Khokha V., Kiguba R., Kirkpatrick A. W., Korner H., Koike K., Kok K. Y. Y., Kon K., Kong V., Inaba K., Ioannidis O., Isik A., Iskandar K., Labbate M., Labricciosa F. M., Lagrou K., Lagunes L., Latifi R., Lasithiotakis K., Laxminarayan R., Lee J. G., Leone M., Leppaniemi A., Li Y., Liang S. Y., Liau K. -H., Litvin A., Loho T., Lowman W., Machain G. M., Maier R. V., Manzano-Nunez R., Marinis A., Marmorale C., Martin-Loeches I., Marwah S., Maseda E., McFarlane M., De Melo R. B., Melotti M. R., Memish Z., Mertz D., Mesina C., Menichetti F., Mishra S. K., Montori G., Moore E. E., Moore F. A., Naidoo N., Napolitano L., Negoi I., Nicolau D. P., Nikolopoulos I., Nord C. E., Ofori-Asenso R., Olaoye I., Omari A. H., Ordonez C. A., Ouadii M., Ouedraogo A. -S., Pagani L., Paiva J. A., Parreira J. G., Pata F., Pereira J., Pereira N. R., Petrosillo N., Picetti E., Pintar T., Ponce-De-Leon A., Popovski Z., Poulakou G., Preller J., Guerrero A. P., Pupelis G., Quiodettis M., Rawson T. M., Reichert M., Reinhart K., Rems M., Rello J., Rizoli S., Roberts J., Rubio-Perez I., Ruppe E., Sakakushev B., Sall I., Kafil H. S., Sanders J., Sato N., Sawyer R. G., Scalea T., Scibe R., Scudeller L., Lohse H. S., Sganga G., Shafiq N., Shah J. N., Spigaglia P., Suroowan S., Tsioutis C., Sifri C. D., Siribumrungwong B., Sugrue M., Talving P., Tan B. K., Tarasconi A., Tascini C., Tilsed J., Timsit J. -F., Tumbarello M., Trung N. T., Ulrych J., Uranues S., Velmahos G., Vereczkei A. G., Viale P., Estape J. V., Viscoli C., Wagenlehner F., Wright B. J., Xiao Y., Yuan K. -C., Zachariah S. K., Zahar J. R., Mergulhao P., and Catena F.

Abstract

This declaration, signed by an interdisciplinary task force of 234 experts from 83 different countries with different backgrounds, highlights the threat posed by antimicrobial resistance and the need for appropriate use of antibiotic agents and antifungal agents in hospitals worldwide especially focusing on surgical infections. As such, it is our intent to raise awareness among healthcare workers and improve antimicrobial prescribing. To facilitate its dissemination, the declaration was translated in different languages.

Published
2017

13. QUALITY OF ANTIBIOTIC PRESCRIBING FOR PROPHYLAXIS IN GENERAL SURGERY: RESULTS FROM 15 GENERAL SURGERY DEPARTMENTS IN 10 COUNTRIES: O53

Author

Papaioannidou, P., Kamparoudis, A., Sabo, A., Vlahovic-Palcevski, V., Benko, R., Loncar-Stojiljkovic, D., Pejakov, L., Beovic, B., Velickovic-Radovanovic, R., Raskovic, A., Jakovljevic, M., Jankovic, S., Papanikolaou, C., Demirkan, A., Melli, M., Vaishnav, R., Karageorgiou, H., Benoni, G. M., Cuzzolin, L., Tsalidou, M., Saoulidis, S., Machado, N., Hatzitheoharis, G., Gerasimidis, T., and Velo, G.

Published
2009

16. ESCMID generic competencies in antimicrobial prescribing and stewardship: towards a European consensus

Author

Dyar, O.J., Beovic, B., Pulcini, C., Tacconelli, E., Hulscher, M.E.J.L., Cookson, B., Dyar, O.J., Beovic, B., Pulcini, C., Tacconelli, E., Hulscher, M.E.J.L., and Cookson, B.

Abstract

Contains fulltext : 202235.pdf (publisher's version ) (Open Access), OBJECTIVE: To develop a consensus-based set of generic competencies in antimicrobial prescribing and stewardship for European prescribers through a structured consensus procedure. METHODS: The RAND-modified Delphi procedure comprised two online questionnaire rounds, a face-to-face meeting between rounds, and a final review. Our departure point was a set of competencies agreed previously by consensus among a UK multi-disciplinary panel, and which had been subsequently revised through consultation with ESCMID Study Group representatives. The 46 draft competency points were reviewed by an expert panel consisting of specialists in infectious diseases and clinical microbiology, and pharmacists. Each proposed competency was assessed using a nine-point Likert scale, for relevance as a minimum standard for all independent prescribers in all European countries. RESULTS: A total of 65 expert panel members participated, from 24 European countries (one to six experts per country). There was very high satisfaction (98%) with the final competencies set, which included 35 competency points, in three sections: core concepts in microbiology, pathogenesis and diagnosing infections (11 points); antimicrobial prescribing (20 points); and antimicrobial stewardship (4 points). CONCLUSIONS: The consensus achieved enabled the production of generic antimicrobial prescribing and stewardship competencies for all European independent prescribers, and of possible global utility. These can be used for training and can be further adapted to the needs of specific professional groups.

Published
2019

18. Antibiotic treatment of infections caused by carbapenem-resistant Gram-negative bacilli: an international ESCMID cross-sectional survey among infectious diseases specialists practicing in large hospitals

Author

Papst, L. Beovic, B. Pulcini, C. Durante-Mangoni, E. Rodríguez-Baño, J. Kaye, K.S. Daikos, G.L. Raka, L. Paul, M. Abbo, L. Abgueguen, P. Almirante, B. Azzini, A.M. Bani-Sadr, F. Bassetti, M. Ben-Ami, R. Béraud, G. Botelho-Nevers, E. Bou, G. Boutoille, D. Cabié, A. Cacopardo, B. Cascio, A. Cassir, N. Castelli, F. Cecala, M. Charmillon, A. Chirouze, C. Cisneros, J.M. Colmenero, J.D. Coppola, N. Corcione, S. Dalla Gasperina, D. De la Calle Cabrera, C. Delobel, P. Di Caprio, D. Dupon, M. Ettahar, N. Falagas, M.E. Falcone, M. Fariñas, M.C. Faure, E. Forestier, E. Foti, G. Gallagher, J. Gattuso, G. Gendrin, V. Gentile, I. Giacobbe, D.R. Gogos, C.A. Grandiere Perez, L. Hansmann, Y. Horcajada, J.P. Iacobello, C. Jacob, J.T. Justo, J.A. Kernéis, S. Komnos, A. Kotnik Kevorkijan, B. Lebeaux, D. Le Berre, R. Lechiche, C. Le Moxing, V. Lescure, F.X. Libanore, M. Martinot, M. Merino de Lucas, E. Mondain, V. Mondello, P. Montejo, M. Mootien, J. Muñoz, P. Nir-Paz, R. Pan, A. Paño-Pardo, J.R. Patel, G. Pérez Rodríguez, M.T. Piroth, L. Pogue, J. Potoski, B.A. Pourcher, V. Pyrpasopoulou, A. Rahav, G. Rizzi, M. Salavert, M. Scheetz, M. Sims, M. Spahija, G. Stefani, S. Stefos, A. Tamma, P.D. Tattevin, P. Tedesco, A. Torre-Cisneros, J. Tripolitsioti, P. Tsiodras, S. Uomo, G. Verdon, R. Viale, P. Vitrat, V. Weinberger, M. Wiener-Well, Y. ESGAP, ESGBIS, ESGIE the CRGNB treatment survey study group

Abstract

Objectives: To explore contemporary antibiotic management of infections caused by carbapenem-resistant Gram-negative bacteria in hospitals. Methods: Cross-sectional, internet-based questionnaire survey. We contacted representatives of all hospitals with more than 800 acute-care hospital beds in France, Greece, Israel, Italy, Kosovo, Slovenia, Spain and selected hospitals in the USA. We asked respondents to describe the most common actual practice at their hospital regarding management of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa through close-ended questions. Results: Between January and June 2017, 115 of 141 eligible hospitals participated (overall response rate 81.6%, country-specific rates 66.7%–100%). Most were tertiary-care (99/114, 86.8%), university-affiliated (110/115, 89.1%) hospitals and most representatives were infectious disease specialists (99/115, 86.1%). Combination therapy was prescribed in 114/115 (99.1%) hospitals at least occasionally. Respondents were more likely to consider combination therapy when treating bacteraemia, pneumonia and central nervous system infections and for Enterobacteriaceae, P. aeruginosa and A. baumannii similarly. Combination of a polymyxin with a carbapenem was used in most cases, whereas combinations of a polymyxin with tigecycline, an aminoglycoside, fosfomycin or rifampicin were also common. Monotherapy was used for treatment of complicated urinary tract infections, usually with an aminoglycoside or a polymyxin. The intended goal of combination therapy was to improve the effectiveness of the treatment and to prevent development of resistance. In general, respondents shared the misconception that combination therapy is supported by strong scientific evidence. Conclusions: Combination therapy was the preferred treatment strategy for infections caused by carbapenem-resistant Gram-negative bacteria among hospital representatives, even though high-quality evidence for carbapenem-based combination therapy is lacking. © 2018 European Society of Clinical Microbiology and Infectious Diseases

Published
2018

22. Central nervous system infections in the absence of cerebrospinal fluid pleocytosis

Author

Erdem, H., Ozturk-Engin, D., Cag, Y., Senbayrak, S., Inan, A., Kazak, E., Savasci, U., Elaldi, N., Vahaboglu, H., Hasbun, R., Nechifor, M., Tireli, H., Kilicoglu, G., Defres, S., Gulsun, S., Ceran, N., Crisan, A., Johansen, I.S., Namiduru, M., Dayan, S., Kayabas, U., Parlak, E., Khalifa, A., Kursun, E., Sipahi, O.R., Yemisen, M., Akbulut, A., Bitirgen, M., Popovic, N., Kandemir, B., Luca, C., Parlak, M., Stahl, J.P., Pehlivanoglu, F., Simeon, S., Ulu-Kilic, A., Yasar, K., Yilmaz, G., Yilmaz, E., Beovic, B., Catroux, M., Lakatos, B., Sunbul, M., Oncul, O., Alabay, S., Sahin-Horasan, E., Kose, S., Shehata, G., Andre, K., Dragovac, G., Gul, H.C., Karakas, A., Chadapaud, S., Hansmann, Y., Harxhi, A., Kirova, V., Masse-Chabredier, I., Oncu, S., Sener, A., Tekin, R., Deveci, O., Ozkaya, H.D., Karabay, O., Agalar, C., Gencer, S., Karahocagil, M.K., Karsen, H., Kaya, S., Pekok, A.U., Celen, M.K., Deniz, S., Ulug, M., Demirdal, T., Guven, T., Bolukcu, S., Avci, M., Nayman-Alpat, S., Yaşar, K., Pehlivanoʇlu, F., Ates-Guler, S., Mutlu-Yilmaz, E., Tosun, S., Sirmatel, F., Batirel, A., Öztoprak, N., Kadanali, A., Turgut, H., Baran, A.I., Karaahmetoglu, G., Sunnetcioglu, M., Haykir-Solay, A., Denk, A., Ayaz, C., Gorenek, L., Larsen, L., Poljak, M., Barsic, B., Argemi, X., Sørensen, S.M., Bohr, A.L., Tattevin, P., Gunst, J.D., Baštáková, L., Jereb, M., Chehri, M., Beraud, G., Del Vecchio, R.F., Maresca, M., Yilmaz, H., Sharif-Yakan, A., Kanj, S.S., Korkmaz, F., Komur, S., Coskuner, S.A., Ince, N., Akkoyunlu, Y., Halac, G., Nemli, S.A., Ak, O., Gunduz, A., Gozel, M.G., Hatipoglu, M., Cicek-Senturk, G., Akcam, F.Z., Inkaya, A.C., Sagmak-Tartar, A., Ersoy, Y., Tuncer-Ertem, G., Balkan, I.I., Cetin, B., Ersoz, G., Ozgunes, N., Yesilkaya, A., Erturk, A., Gundes, S., Turhan, V., Yalci, A., Aydin, E., Diktas, H., Ulcay, A., Seyman, D., and Leblebicioglu, H.

Subjects
protein cerebrospinal fluid level, Male, pleocytosis, Meningitis, Pneumococcal, Leukocytosis, herpes simplex encephalitis, CSF, Leukocyte, brucella meningitis, Article, cerebrospinal fluid, clinical feature, female, Central Nervous System Infections, tuberculous meningitis, Tuberculosis, Meningeal, central nervous system infection, middle aged, neurosyphilis, Encephalitis, Humans, pathology, Meningitis, human, pneumococcal meningitis
Abstract

Previous multicenter/multinational studies were evaluated to determine the frequency of the absence of cerebrospinal fluid pleocytosis in patients with central nervous system infections, as well as the clinical impact of this condition. It was found that 18% of neurosyphilis, 7.9% of herpetic meningoencephalitis, 3% of tuberculous meningitis, 1.7% of Brucella meningitis, and 0.2% of pneumococcal meningitis cases did not display cerebrospinal fluid pleocytosis. Most patients were not immunosuppressed. Patients without pleocytosis had a high rate of unfavorable outcomes and thus this condition should not be underestimated. © 2017 The Author(s)

Published
2017

25. Forgotten antibiotics: a follow-up inventory study in Europe, the USA, Canada and Australia

Author

Pulcini, C., Mohrs, S., Beovic, B., Gyssens, I.C., Theuretzbacher, U., Cars, O., Pulcini, C., Mohrs, S., Beovic, B., Gyssens, I.C., Theuretzbacher, U., and Cars, O.

Abstract

Contains fulltext : 174744.pdf (publisher's version ) (Closed access), The objective of this study was to update a 2011 survey, conducted on behalf of the ESCMID Study Group for Antibiotic Policies (ESGAP), studying the availability of old but clinically useful antibiotics in North America, Europe and Australia. This follow-up survey was performed in 2015 in 40 countries among specialists from the pharmaceutical, infectious diseases and microbiology sectors in North America, Europe and Australia in order to assess the availability through usual marketing processes of 36 systemic antibiotics (addition of 3 antibiotics compared with the 2011 survey) selected for their ability to treat infections caused by resistant bacteria and their unique value for specific criteria. The questionnaire was sent by e-mail to national contacts belonging to ESGAP and ReAct networks. In all, 39 of the 40 countries participated in this survey. The number of available antibiotics differed considerably from one drug to another as well as from one country to another (e.g. 7 antibiotics available in Estonia, 24 in France). Overall, 25/36 selected antibiotics were marketed in 20/39 countries or less. From 2011 to 2015 (data available for both periods in 37 countries for 33 antibiotics), the number of available selected antibiotics increased in 13 countries and decreased in 17. In conclusion, despite the ongoing bacterial resistance crisis, the situation regarding the availability of 'forgotten antibiotics' has worsened since 2011. Urgent measures are needed to ensure better availability of these antibiotics on a global scale as a conservation measure to ensure sustainable and responsible use of antibiotics.

Published
2017

26. ESGAP inventory of target indicators assessing antibiotic prescriptions: A cross-sectional survey

Author

Howard, P., Huttner, B., Beovic, B., Beraud, G., Kofteridis, D. P., Pardo, J. P., Schouten, J., Pulcini, C., Angioni, G., Arvaniti, K., Barac, A., Bolla, C., Calbo, E., Dyar, O. -J., Fantoni, Massimo, Fjeld, H., Keuleyan, E., Kumar, S., Harhxi, A., Jenkins, D., Maurer, F. P., Messiaen, P., Baranda, M. M., Munoz, P., Orlando, G., Pagani, L., Pepe, F., Gentil, P. R., Pereira, N. M. R., Rodrigues-Bano, J., Skodvin, B., Tangden, T., Vitrat, V., Vlahovic-Palcevski, V., Wechsler-Fordos, A., Zarb, P., Fantoni M. (ORCID:0000-0001-6913-8460), Howard, P., Huttner, B., Beovic, B., Beraud, G., Kofteridis, D. P., Pardo, J. P., Schouten, J., Pulcini, C., Angioni, G., Arvaniti, K., Barac, A., Bolla, C., Calbo, E., Dyar, O. -J., Fantoni, Massimo, Fjeld, H., Keuleyan, E., Kumar, S., Harhxi, A., Jenkins, D., Maurer, F. P., Messiaen, P., Baranda, M. M., Munoz, P., Orlando, G., Pagani, L., Pepe, F., Gentil, P. R., Pereira, N. M. R., Rodrigues-Bano, J., Skodvin, B., Tangden, T., Vitrat, V., Vlahovic-Palcevski, V., Wechsler-Fordos, A., Zarb, P., and Fantoni M. (ORCID:0000-0001-6913-8460)

Abstract

Background A variety of indicators is commonly used to monitor antibiotic prescriptions as part of national antimicrobial stewardship (AMS) programmes. Objectives To make an inventory of indicators that assess antibiotic prescriptions and are linked to specific targets and incentives, at a national level. Methods A cross-sectional survey (three-item questionnaire) was conducted in 2017 among all ESGAP (ESCMID Study Group for Antimicrobial stewardshiP) members, coming from 23 European countries and 16 non-European countries. Results Almost all (20/23, 87%) European countries belonging to the ESGAP network participated, as well as one non-European country. Computerized systems routinely linking antibiotic prescriptions to clinical diagnoses were reported for only two countries (Turkey and Croatia). Only 6/21 (29%) countries had national indicators with both clear targets and incentives (Bulgaria, Croatia, France, the Netherlands, Norway and Portugal). We identified a total of 21 different indicators used in these countries, 16 concerning inpatients (9 quality indicators and 7 quantity metrics) and 8 concerning outpatients (all quantity metrics); some indicators were used in both settings. Three types of incentives were used: financing mechanism, hospitals' accreditation and public reporting. Some respondents reported that such indicators with both clear targets and incentives were used at a regional level in their country (e.g. Andalusia in Spain and England in the UK). Conclusions National indicators, with clear targets and incentives, are not commonly used in Europe and we observed wide variations between countries regarding the selected indicators, the units of measure and the chosen targets.

Published
2017

28. Amoxicillin dosing recommendations are very different in European countries: a cross-sectional survey

Author

Pulcini, C., primary, Beovic, B., additional, Cavalié, P., additional, Deptula, A., additional, Dyar, O., additional, Gyssens, I., additional, Kern, W., additional, Knepper, V., additional, Kofteridis, D., additional, Hanberger, H., additional, Huttner, B., additional, Messiaen, P., additional, Pagani, L., additional, Pano Pardo, J., additional, Pulcini, C., additional, Rodriguez-Bano, J., additional, Skov Simonsen, G., additional, Vlahović-Palčevski, V., additional, and Zarb, P., additional

Published
2017
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29. Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09-related pneumonia: an IPD meta-analysis

Author

Muthuri, SG, Venkatesan, S, Myles, PR, Leonardi-Bee, J, Lim, WS, Mamun, AA, Anovadiya, AP, Araújo, WN, Azziz-Baumgartner, E, Báez, C, Bantar, C, Barhoush, MM, Bassetti, M, Beovic, B, Bingisser, R, Bonmarin, I, Borja-Aburto, VH, Cao, B, Carratala, J, Cuezzo, MR, Denholm, JT, Dominguez, SR, Duarte, PA, Dubnov-Raz, G, Echavarria, M, Fanella, S, Fraser, J, Gao, Z, Gérardin, P, Giannella, M, Gubbels, S, Herberg, J, Iglesias, AL, Hoeger, PH, Hoffmann, M, Hu, X, Islam, QT, Jiménez, MF, Kandeel, A, Keijzers, G, Khalili, H, Khandaker, G, Knight, M, Kusznierz, G, Kuzman, I, Kwan, AM, Amine, IL, Langenegger, E, Lankarani, KB, Leo, YS, Linko, R, Liu, P, Madanat, F, Manabe, T, Mayo-Montero, E, McGeer, A, Memish, ZA, Metan, G, Mikić, D, Mohn, KG, Moradi, A, Nymadawa, P, Ozbay, B, Ozkan, M, Parekh, D, Paul, M, Poeppl, W, Polack, FP, Rath, BA, Rodríguez, AH, Siqueira, MM, Skręt-Magierło, J, Talarek, E, Tang, JW, Torres, A, Törün, SH, Tran, D, Uyeki, TM, Van Zwol, A, Vaudry, W, Velyvyte, D, Vidmar, T, Zarogoulidis, P, PRIDE Consortium Investigators, and Nguyen-Van-Tam, JS

Subjects
1117 Public Health And Health Services, hospitalisation, Virology, individual participant data meta-analyses, 1103 Clinical Sciences, Influenza-related pneumonia, neuraminidase inhibitors, PRIDE Consortium Investigators
Published
2015

30. Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09-related pneumonia: an individual participant data meta-analysis

Author

Muthuri, SG, Venkatesan, S, Myles, PR, Leonardi-Bee, J, Lim, WS, Al Mamun, A, Anovadiya, AP, Araujo, WN, Azziz-Baumgartner, E, Baez, C, Bantar, C, Barhoush, MM, Bassetti, M, Beovic, B, Bingisser, R, Bonmarin, I, Borja-Aburto, VH, Cao, B, Carratala, J, Cuezzo, MR, Denholm, JT, Dominguez, SR, Duarte, PAD, Dubnov-Raz, G, Echavarria, M, Fanella, S, Fraser, J, Gao, Z, Gerardin, P, Giannella, M, Gubbels, S, Herberg, J, Higuera Iglesias, AL, Hoeger, PH, Hoffmann, M, Hu, X, Islam, QT, Jimenez, MF, Kandeel, A, Keijzers, G, Khalili, H, Khandaker, G, Knight, M, Kusznierz, G, Kuzman, I, Kwan, AMC, Lahlou Amine, I, Langenegger, E, Lankarani, KB, Leo, Y-S, Linko, R, Liu, P, Madanat, F, Manabe, T, Mayo-Montero, E, McGeer, A, Memish, ZA, Metan, G, Mikic, D, Mohn, KGI, Moradi, A, Nymadawa, P, Ozbay, B, Ozkan, M, Parekh, D, Paul, M, Poeppl, W, Polack, FP, Rath, BA, Rodriguez, AH, Siqueira, MM, Skret-Magierlo, J, Talarek, E, Tang, JW, Torres, A, Torun, SH, Tran, D, Uyeki, TM, van Zwol, A, Vaudry, W, Velyvyte, D, Vidmar, T, Zarogoulidis, P, Nguyen-Van-Tam, JS, Muthuri, SG, Venkatesan, S, Myles, PR, Leonardi-Bee, J, Lim, WS, Al Mamun, A, Anovadiya, AP, Araujo, WN, Azziz-Baumgartner, E, Baez, C, Bantar, C, Barhoush, MM, Bassetti, M, Beovic, B, Bingisser, R, Bonmarin, I, Borja-Aburto, VH, Cao, B, Carratala, J, Cuezzo, MR, Denholm, JT, Dominguez, SR, Duarte, PAD, Dubnov-Raz, G, Echavarria, M, Fanella, S, Fraser, J, Gao, Z, Gerardin, P, Giannella, M, Gubbels, S, Herberg, J, Higuera Iglesias, AL, Hoeger, PH, Hoffmann, M, Hu, X, Islam, QT, Jimenez, MF, Kandeel, A, Keijzers, G, Khalili, H, Khandaker, G, Knight, M, Kusznierz, G, Kuzman, I, Kwan, AMC, Lahlou Amine, I, Langenegger, E, Lankarani, KB, Leo, Y-S, Linko, R, Liu, P, Madanat, F, Manabe, T, Mayo-Montero, E, McGeer, A, Memish, ZA, Metan, G, Mikic, D, Mohn, KGI, Moradi, A, Nymadawa, P, Ozbay, B, Ozkan, M, Parekh, D, Paul, M, Poeppl, W, Polack, FP, Rath, BA, Rodriguez, AH, Siqueira, MM, Skret-Magierlo, J, Talarek, E, Tang, JW, Torres, A, Torun, SH, Tran, D, Uyeki, TM, van Zwol, A, Vaudry, W, Velyvyte, D, Vidmar, T, Zarogoulidis, P, and Nguyen-Van-Tam, JS

Abstract

BACKGROUND: The impact of neuraminidase inhibitors (NAIs) on influenza-related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection. METHODS: A worldwide meta-analysis of individual participant data from 20 634 hospitalised patients with laboratory-confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) 'pandemic influenza'. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. RESULTS: Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64-1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44-1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71-1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55-0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54-0·85; P = 0·001)]. CONCLUSIONS: Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support.

Published
2016

31. Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data

Author

Muthuri, SG, Venkatesan, S, Myles, PR, Leonardi-Bee, J, Al Khuwaitir, TSA, Al Mamun, A, Anovadiya, AP, Azziz-Baumgartner, E, Báez, C, Bassetti, M, Beovic, B, Bertisch, B, Bonmarin, I, Booy, R, Borja-Aburto, VH, Burgmann, H, Cao, B, Carratala, J, Denholm, JT, Dominguez, SR, Duarte, PAD, Dubnov-Raz, G, Echavarria, M, Fanella, S, Gao, Z, Gérardin, P, Giannella, M, Gubbels, S, Herberg, J, Higuera Iglesias, AL, Hoger, PH, Hu, X, Islam, QT, Jiménez, MF, Kandeel, A, Keijzers, G, Khalili, H, Knight, M, Kudo, K, Kusznierz, G, Kuzman, I, Kwan, AMC, Amine, IL, Langenegger, E, Lankarani, KB, Leo, Y-S, Linko, R, Liu, P, Madanat, F, Mayo-Montero, E, McGeer, A, Memish, Z, Metan, G, Mickiene, A, Mikic, D, Mohn, KGI, Moradi, A, Nymadawa, P, Oliva, ME, Ozkan, M, Parekh, D, Paul, M, Polack, FP, Rath, BA, Rodríguez, AH, Sarrouf, EB, Seale, AC, Sertogullarindan, B, Siqueira, MM, Skret-Magierlo, J, Stephan, F, Talarek, E, Tang, JW, To, KKW, Torres, A, Törün, SH, Tran, D, Uyeki, TM, van Zwol, A, Vaudry, W, Vidmar, T, Yokota, RTC, Zarogoulidis, P, Nguyen-van-Tam, JS, Aguiar-Oliveira, ML, Al Masri, M, Amin, R, Araújo, WN, Ballester-Orcal, E, Bantar, C, Bao, J, Barhoush, MM, Basher, A, Bautista, E, Bettinger, J, Bingisser, R, Bouza, E, Bozkurt, I, Celjuska-Tošev, E, Chan, KKC, Chen, Y, Chinbayar, T, Cilloniz, C, Cox, RJ, Cuezzo, MR, Cui, W, Dashti-Khavidaki, S, du, B, El Rhaffouli, H, Escobar, H, Florek-Michalska, A, Fraser, J, Gerrard, J, Gormley, S, Götberg, S, Hoffmann, M, Honarvar, B, Hu, J, Kemen, C, Khandaker, G, Koay, KSC, Kojic, M, Kyaw, WM, Leibovici, L, Li, H, Li, X-L, Libster, R, Loh, TP, Macbeth, D, Maltezos, E, Manabe, T, Marcone, DN, Marczynska, M, Mastalir, FP, Moghadami, M, Moriconi, L, Ozbay, B, Pečavar, B, Poeppl, W, Poliquin, PG, Rahman, M, Rascon-Pacheco, A, Refaey, S, Schweiger, B, Smith, FG, Somer, A, Souza, TML, Tabarsi, P, Tripathi, CB, Velyvyte, D, Viasus, D, Yu, Q, Yuen, K-Y, Zhang, W, Zuo, W, Pediatric surgery, CCA - Innovative therapy, Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S. A., Al Mamun, Adbullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A.D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L., Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Amine, Idriss Lahlou, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Fari, Mayo-Montero, Elga, Mcgeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Aukse, Mikic, Dragan, Mohn, Kristin G.I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skret-Magierlo, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K.W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelie, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T.C., Zarogoulidis, Paul, Nguyen-van-Tam, Jonathan S, Aguiar-Oliveira, Maria de Lourde, Al Masri, Malakita, Amin, Robed, Araújo, Wildo N., Ballester-Orcal, Elena, Bantar, Carlo, Bao, Jing, Barhoush, Mazen M., Basher, Ariful, Bautista, Edgar, Bettinger, Julie, Bingisser, Roland, Bouza, Emilio, Bozkurt, Ilkay, Celjuska-Tošev, Elvira, Chan, Kenny K.C., Chen, Yusheng, Chinbayar, Tserendorj, Cilloniz, Catia, Cox, Rebecca J., Cuezzo, María R., Cui, Wei, Dashti-Khavidaki, Simin, Du, Bin, El Rhaffouli, Hicham, Escobar, Hernan, Florek-Michalska, Agnieszka, Fraser, Jame, Gerrard, John, Gormley, Stuart, Götberg, Sandra, Hoffmann, Matthia, Honarvar, Behnam, Hu, Jianmin, Kemen, Christoph, Khandaker, Gulam, Koay, Evelyn S. C., Kojic, Miroslav, Kyaw, Win M., Leibovici, Leonard, Li, Hongru, Li, Xiao-Li, Libster, Romina, Loh, Tze P., Macbeth, Deborough, Maltezos, Efstratio, Manabe, Toshie, Marcone, Débora N., Marczynska, Magdalena, Mastalir, Fabiane P., Moghadami, Mohsen, Moriconi, Lilian, Ozbay, Bulent, Pečavar, Blaž, Poeppl, Wolfgang, Poliquin, Philippe G., Rahman, Mahmudur, Rascon-Pacheco, Alberto, Refaey, Samir, Schweiger, Brunhilde, Smith, Fang G., Somer, Ayper, Souza, Thiago M. L., Tabarsi, Payam, Tripathi, Chandrabhanu B., Velyvyte, Daiva, Viasus, Diego, Yu, Qin, Yuen, Kwok-Yung, Zhang, Wei, and Zuo, Wei

Subjects
Male, ANTIVIRAL TREATMENT, IMPACT, Respiratory System, CHILDREN, Neuraminidase inhibitors, Pandemic influenza, Mortality, Meta-analysis, medicine.disease_cause, THERAPY, chemistry.chemical_compound, Influenza A Virus, H1N1 Subtype, 0302 clinical medicine, Pandemic, Influenza A Virus, Influenza A virus, Zanamivir, 030212 general & internal medicine, Enzyme Inhibitors, Child, OUTCOMES, 0303 health sciences, biology, Neuraminidase inhibitor, Medicine (all), virus diseases, Middle Aged, 3. Good health, Hospitalization, Treatment Outcome, Female, Life Sciences & Biomedicine, Adolescent, Adult, Antiviral Agents, Humans, Influenza, Human, Neuraminidase, Oseltamivir, Proportional Hazards Models, Young Adult, Pandemics, Pulmonary and Respiratory Medicine, Human, medicine.drug, medicine.medical_specialty, medicine.drug_class, PANDEMIC INFLUENZA, Article, PRIDE Consortium Investigators, 03 medical and health sciences, Critical Care Medicine, General & Internal Medicine, Internal medicine, medicine, H1N1 Subtype, Intensive care medicine, Science & Technology, 030306 microbiology, business.industry, STEM-CELL TRANSPLANTATION, ADULTS, Odds ratio, Influenza, chemistry, RISK-FACTORS, biology.protein, business
Abstract

Background: Neuraminidase inhibitors were widely used during the 2009-10 influenza A H1N1 pandemic, but evidence for their effectiveness in reducing mortality is uncertain. We did a meta-analysis of individual participant data to investigate the association between use of neuraminidase inhibitors and mortality in patients admitted to hospital with pandemic influenza A H1N1pdm09 virus infection. Methods: We assembled data for patients (all ages) admitted to hospital worldwide with laboratory confirmed or clinically diagnosed pandemic influenza A H1N1pdm09 virus infection. We identified potential data contributors from an earlier systematic review of reported studies addressing the same research question. In our systematic review, eligible studies were done between March 1, 2009 (Mexico), or April 1, 2009 (rest of the world), until the WHO declaration of the end of the pandemic (Aug 10, 2010); however, we continued to receive data up to March 14, 2011, from ongoing studies. We did a meta-analysis of individual participant data to assess the association between neuraminidase inhibitor treatment and mortality (primary outcome), adjusting for both treatment propensity and potential confounders, using generalised linear mixed modelling. We assessed the association with time to treatment using time-dependent Cox regression shared frailty modelling. Findings: We included data for 29234 patients from 78 studies of patients admitted to hospital between Jan 2, 2009, and March 14, 2011. Compared with no treatment, neuraminidase inhibitor treatment (irrespective of timing) was associated with a reduction in mortality risk (adjusted odds ratio [OR] 0·81; 95% CI 0·70-0·93; p=0·0024). Compared with later treatment, early treatment (within 2 days of symptom onset) was associated with a reduction in mortality risk (adjusted OR 0·48; 95% CI 0·41-0·56; p

Published
2014

32. Estimating the burden of pneumococcal pneumonia among adults: a systematic review and meta-analysis of diagnostic techniques

Author

Said MA, Johnson HL, Nonyane BA, Deloria-Knoll M, O'Brien KL, AGEDD Adult Pneumococcal Burden Study Team, Andreo F, Beovic B, Blanco S, Boersma WG, Boulware DR, Butler JC, Carratalà J, Chang FY, Charles PG, Diaz AA, Domínguez J, Ehara N, Endeman H, Falcó V, Falguera M, Fukushima K, Garcia-Vidal C, Genne D, Guchev IA, Gutierrez F, Hernes SS, Hoepelman AI, Hohenthal U, Johansson N, Kolek V, Kozlov RS, Lauderdale TL, Mareković, Ivana, Masiá M, Matta MA, Miró Ò, Murdoch DR, Nuermberger E, Paolini R, Perelló R, Snijders D, Plečko, Vanda, and Sordé R, Strålin K, van der Eerden MM, Vila-Corcoles A, Watt JP.

Subjects
pneumococcal pneumonia, meta-analysis, diagnostic techniques
Abstract

Pneumococcal pneumonia causes significant morbidity and mortality among adults. Given limitations of diagnostic tests for non-bacteremic pneumococcal pneumonia, most studies report the incidence of bacteremic or invasive pneumococcal disease (IPD), and thus, grossly underestimate the pneumococcal pneumonia burden. We aimed to develop a conceptual and quantitative strategy to estimate the non-bacteremic disease burden among adults with community-acquired pneumonia (CAP) using systematic study methods and the availability of a urine antigen assay. We performed a systematic literature review of studies providing information on the relative yield of various diagnostic assays (BinaxNOW® S. pneumoniae urine antigen test (UAT) with blood and/or sputum culture) in diagnosing pneumococcal pneumonia. We estimated the proportion of pneumococcal pneumonia that is bacteremic, the proportion of CAP attributable to pneumococcus, and the additional contribution of the Binax UAT beyond conventional diagnostic techniques, using random effects meta-analytic methods and bootstrapping. We included 35 studies in the analysis, predominantly from developed countries. The estimated proportion of pneumococcal pneumonia that is bacteremic was 24.8% (95% CI: 21.3%, 28.9%). The estimated proportion of CAP attributable to pneumococcus was 27.3% (95% CI: 23.9%, 31.1%). The Binax UAT diagnosed an additional 11.4% (95% CI: 9.6, 13.6%) of CAP beyond conventional techniques. We were limited by the fact that not all patients underwent all diagnostic tests and by the sensitivity and specificity of the diagnostic tests themselves. We address these resulting biases and provide a range of plausible values in order to estimate the burden of pneumococcal pneumonia among adults. Estimating the adult burden of pneumococcal disease from bacteremic pneumococcal pneumonia data alone significantly underestimates the true burden of disease in adults. For every case of bacteremic pneumococcal pneumonia, we estimate that there are at least 3 additional cases of non-bacteremic pneumococcal pneumonia.

Published
2013

35. Actinomyces in chronic granulomatous disease: an emerging and unanticipated pathogen

Author

Reichenbach, J, Lopatin, U, Mahlaoui, N, Beovic, B, Siler, U, Zbinden, R, Seger, R A, Galmiche, L, Brousse, N, Kayal, S, Güngör, Tayfun; https://orcid.org/0000-0002-3261-1186, Blanche, S, Holland, S M, Reichenbach, J, Lopatin, U, Mahlaoui, N, Beovic, B, Siler, U, Zbinden, R, Seger, R A, Galmiche, L, Brousse, N, Kayal, S, Güngör, Tayfun; https://orcid.org/0000-0002-3261-1186, Blanche, S, and Holland, S M

Abstract

BACKGROUND: Chronic granulomatous disease (CGD) is a rare inherited disease of the phagocyte NADPH oxidase system that causes defective production of toxic oxygen metabolites, impaired bacterial and fungal killing, and recurrent life-threatening infections, mostly by catalase-producing organisms. We report for the first time, to our knowledge, chronic infections with Actinomyces species in 10 patients with CGD. Actinomycosis is a chronic granulomatous condition that commonly manifests as cervicofacial, pulmonary, or abdominal disease, caused by slowly progressive infection with oral and gastrointestinal commensal Actinomyces species. Treatment of actinomycosis is usually simple in immunocompetent individuals, requiring long-term, high-dose intravenous penicillin, but is more complicated in those with CGD because of delayed diagnosis and an increased risk of chronic invasive or debilitating disease. METHODS: Actinomyces was identified by culture, staining, 16S ribosomal DNA polymerase chain reaction, and/or a complement fixation test in 10 patients with CGD. RESULTS: All 10 patients presented with a history of fever and elevated inflammatory signs without evident focus. Diagnosis was delayed and clinical course severe and protracted despite high-dose intravenous antibiotic therapy and/or surgery. These results suggest an unrecognized and unanticipated susceptibility to weakly pathogenic Actinomyces species in patients with CGD because these are catalase-negative organisms previously thought to be nonpathogenic in CGD. CONCLUSIONS: Actinomycosis should be vigorously sought and promptly treated in patients with CGD presenting with uncommon and prolonged clinical signs of infection. Actinomycosis is a catalase-negative infection important to consider in CGD.

Published
2009

44. Antibiotic treatment of infections caused by carbapenem-resistant Gram-negative bacilli: an international ESCMID cross-sectional survey among infectious diseases specialists practicing in large hospitals

Author

Papst, Lea, Beović, Bojana, Pulcini, Céline, Durante-Mangoni, Emanuele, Rodríguez-Baño, Jesús, Kaye, Keith S, Daikos, George L, Raka, Lul, Paul, Mical, Esgap, Esgbis, ESGIE and the CRGNB treatment survey study group collaborators: Abbo, L, Abgueguen, P, Almirante, B, Azzini, Am, Bani-Sadr, F, Bassetti, M, Ben-Ami, R, Beović, B, Béraud, G, Botelho-Nevers, E, Bou, G, Boutoille, D, Cabié, A, Cacopardo, B, Cascio, A, Cassir, N, Castelli, F, Cecala, M, Charmillon, A, Chirouze, C, Cisneros, Jm, Colmenero, Jd, Coppola, N, Corcione, S, Daikos, Gl, Dalla Gasperina, D, De la Calle Cabrera, C, Delobel, P, Di Caprio, D, Durante Mangoni, E, Dupon, M, Ettahar, N, Falagas, Me, Falcone, M, Fariñas, Mc, Faure, E, Forestier, E, Foti, G, Gallagher, J, Gattuso, G, Gendrin, V, Gentile, I, Giacobbe, Dr, Gogos, Ca, Grandiere Perez, L, Hansmann, Y, Horcajada, Jp, Iacobello, C, Jacob, Jt, Justo, Ja, Kernéis, S, Komnos, A, Kotnik Kevorkijan, B, Lebeaux, D, Le Berre, R, Lechiche, C, Le Moing, V, Lescure, Fx, Libanore, M, Martinot, M, Merino de Lucas, E, Mondain, V, Mondello, P, Montejo, M, Mootien, J, Muñoz, P, Nir-Paz, R, Pan, A, Paño-Pardo, Jr, Patel, G, Paul, M, Pérez Rodríguez MT, Piroth, L, Pogue, J, Potoski, Ba, Pourcher, V, Pyrpasopoulou, A, Rahav, G, Rizzi, M, Rodríguez-Baño, J, Salavert, M, Scheetz, M, Sims, M, Spahija, G, Stefani, S, Stefos, A, Tamma, Pd, Tattevin, P, Tedesco, A, Torre-Cisneros, J, Tripolitsioti, P, Tsiodras, S, Uomo, G, Verdon, R, Viale, P, Vitrat, V, Weinberger, M, Wiener-Well, Y, Papst L., Beovic B., Pulcini C., Durante-Mangoni E., Rodriguez-Bano J., Kaye K.S., Daikos G.L., Raka L., Paul M., Abbo L., Abgueguen P., Almirante B., Azzini A.M., Bani-Sadr F., Bassetti M., Ben-Ami R., Beraud G., Botelho-Nevers E., Bou G., Boutoille D., Cabie A., Cacopardo B., Cascio A., Cassir N., Castelli F., Cecala M., Charmillon A., Chirouze C., Cisneros J.M., Colmenero J.D., Coppola N., Corcione S., Dalla Gasperina D., De la Calle Cabrera C., Delobel P., Di Caprio D., Durante Mangoni E., Dupon M., Ettahar N., Falagas M.E., Falcone M., Farinas M.C., Faure E., Forestier E., Foti G., Gallagher J., Gattuso G., Gendrin V., Gentile I., Giacobbe D.R., Gogos C.A., Grandiere Perez L., Hansmann Y., Horcajada J.P., Iacobello C., Jacob J.T., Justo J.A., Kerneis S., Komnos A., Kotnik Kevorkijan B., Lebeaux D., Le Berre R., Lechiche C., Le Moxing V., Lescure F.X., Libanore M., Martinot M., Merino de Lucas E., Mondain V., Mondello P., Montejo M., Mootien J., Munoz P., Nir-Paz R., Pan A., Pano-Pardo J.R., Patel G., Perez Rodriguez M.T., Piroth L., Pogue J., Potoski B.A., Pourcher V., Pyrpasopoulou A., Rahav G., Rizzi M., Salavert M., Scheetz M., Sims M., Spahija G., Stefani S., Stefos A., Tamma P.D., Tattevin P., Tedesco A., Torre-Cisneros J., Tripolitsioti P., Tsiodras S., Uomo G., Verdon R., Viale P., Vitrat V., Weinberger M., Wiener-Well Y., University Medical Centre Ljubljana [Ljubljana, Slovenia] (UMCL), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Monaldi Hospital, Hospital Virgen Macarena, University of Michigan Medical School [Ann Arbor], University of Michigan [Ann Arbor], University of Michigan System-University of Michigan System, National and Kapodistrian University of Athens (NKUA), University Clinical Center of Kosova, Rambam Health Care Campus, Jackson Memorial Hospital, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Vall d'Hebron University Hospital [Barcelona], University of Verona (UNIVR), Centre Hospitalier Universitaire de Reims (CHU Reims), Ospedale 'Santa Maria della Misericordia' = University Hospital 'Santa Maria della Misericordia', Tel Aviv Sourasky Medical Centre, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Hospital Universitario, A Coruña, Centre hospitalier universitaire de Nantes (CHU Nantes), CHU de la Martinique [Fort de France], ARNAS 'Garibaldi, S. Luigi-Currò, Ascoli-Tomaselli', Università degli studi di Palermo - University of Palermo, Assistance Publique-Hôpitaux de Marseille (AP-HM), ASST Spedali Civili of Brescia, ARNAS Civico Palermo, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hospital Universitario Virgen del Rocío [Sevilla], Hospital Regional Universitario de Málaga [Spain], Università degli studi della Campania 'Luigi Vanvitelli', University of Turin, University of Insubria, Varese, Hospital Clínic de Barcelona, Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], AO San Sebastiano, CHU Bordeaux [Bordeaux], CH Valenciennes, Henry Dunant Hospital, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], Hospital Marques de Valdecillas, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Métropole Savoie [Chambéry], Ospedale di Reggio Calabria, Children’s Hospital of Philadelphia (CHOP ), Carlo Poma Hospital Mantova (ASST Mantova ), CH Belfort-Montbéliard, University of Naples Federico II, AUO San Martino IST Ist Nazl Ric Canc, I-16132 Genoa, Italy, University of Patras [Patras], Centre Hospitalier Le Mans (CH Le Mans), CHU Strasbourg, IMIM-Hospital del Mar, Generalitat de Catalunya, Cannizzaro Hospital, Emory University School of Medicine, Emory University [Atlanta, GA], University of South Carolina [Columbia], AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), General Hospital of Larissa, University medical centre Maribor (UKC Maribor), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), AP-HP - Hôpital Bichat - Claude Bernard [Paris], University of Ferrara at St. Anna Hospital, CH Colmar, Hospital General Universitario de Alicante, CHU Nice [Cimiez], Hôpital Cimiez [Nice] (CHU), AOU Policlinico 'G. Martino', Messina, Italy, Hospital Universitario Cruces = Cruces University Hospital, Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Hospital General Universitario 'Gregorio Marañón' [Madrid], Hadassah Hebrew University Medical Center [Jerusalem], Azienda Istituti Ospitalieri di Cremona, Lozano Blesa Clinical Hospital [Zaragoza, Spain], Mount Sinai Hospital [Toronto, Canada] (MSH), Complejo Hospitalario de Vigo, CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Detroit Medical Center, University of Pittsburgh Medical Center [Pittsburgh, PA, États-Unis] (UPMC), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hippokration General Hospital, Sheba Medical Centre, Ramat Gan, Israel, ASST Papa Giovanni XXIII [Bergamo, Italy], Hospital Universitario La Fe, Valencia, Northwestern Hospital Chicago, Beaumont Hospital, Lagjia e Universitetit, Rruga 1, nr.32, 10000 Prishtina, Kosovo, parent, Università degli studi di Catania [Catania], Larissa University Hospital, Johns Hopkins University School of Medicine [Baltimore], CHU Pontchaillou [Rennes], Ospedale Fracastoro San Bonifacio [Verona], Hospital Reina Sofia, Cordoba, Agioi Anargiroi Hospital, Attikon University Hospital, Ospedale Cardarelli, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Alma Mater Studiorum Università di Bologna [Bologna] (UNIBO), CH Annecy Genevois, Assah Harofeh Medical Centre, Zerifin, Israel, Shaare Zedek Medical Centre, Jerusalem, Israel, National Institutes of Health (US), Instituto de Salud Carlos III, Ministerio de Economía, Industria y Competitividad (España), Red Española de Investigación en Patología Infecciosa, European Commission, Papst, Lea, Beović, Bojana, Pulcini, Céline, Durante-Mangoni, Emanuele, Rodríguez-Baño, Jesú, Kaye, Keith S, Daikos, George L, Raka, Lul, Paul, Mical, Papst, L., Beovic, B., Pulcini, C., Durante-Mangoni, E., Rodriguez-Bano, J., Kaye, K. S., Daikos, G. L., Raka, L., Paul, M., Abbo, L., Abgueguen, P., Almirante, B., Azzini, A. M., Bani-Sadr, F., Bassetti, M., Ben-Ami, R., Beraud, G., Botelho-Nevers, E., Bou, G., Boutoille, D., Cabie, A., Cacopardo, B., Cascio, A., Cassir, N., Castelli, F., Cecala, M., Charmillon, A., Chirouze, C., Cisneros, J. M., Colmenero, J. D., Coppola, N., Corcione, S., Dalla Gasperina, D., De la Calle Cabrera, C., Delobel, P., Di Caprio, D., Dupon, M., Ettahar, N., Falagas, M. E., Falcone, M., Farinas, M. C., Faure, E., Forestier, E., Foti, G., Gallagher, J., Gattuso, G., Gendrin, V., Gentile, I., Giacobbe, D. R., Gogos, C. A., Grandiere Perez, L., Hansmann, Y., Horcajada, J. P., Iacobello, C., Jacob, J. T., Justo, J. A., Kerneis, S., Komnos, A., Kotnik Kevorkijan, B., Lebeaux, D., Le Berre, R., Lechiche, C., Le Moxing, V., Lescure, F. X., Libanore, M., Martinot, M., Merino de Lucas, E., Mondain, V., Mondello, P., Montejo, M., Mootien, J., Munoz, P., Nir-Paz, R., Pan, A., Pano-Pardo, J. R., Patel, G., Perez Rodriguez, M. T., Piroth, L., Pogue, J., Potoski, B. A., Pourcher, V., Pyrpasopoulou, A., Rahav, G., Rizzi, M., Salavert, M., Scheetz, M., Sims, M., Spahija, G., Stefani, S., Stefos, A., Tamma, P. D., Tattevin, P., Tedesco, A., Torre-Cisneros, J., Tripolitsioti, P., Tsiodras, S., Uomo, G., Verdon, R., Viale, P., Vitrat, V., Weinberger, M., Wiener-Well, Y., Università degli studi di Verona = University of Verona (UNIVR), Assistance Publique - Hôpitaux de Marseille (APHM), Hospital Regional Universitario de Málaga = Regional University Hospital of Malaga [Spain], and Università degli studi di Torino = University of Turin (UNITO)

Subjects
0301 basic medicine, Acinetobacter baumannii, Carbapenem, Antibiotics, Drug Resistance, Drug resistance, Tigecycline, Carbapenem-resistant Gram-negative bacilli, Combination therapy, Enterobacteriaceae, Polymyxin, Pseudomonas aeruginosa, Survey, 0302 clinical medicine, Surveys and Questionnaires, polycyclic compounds, 030212 general & internal medicine, Anti-Bacterial Agents, Carbapenems, Cross Infection, Cross-Sectional Studies, Drug Resistance, Bacterial, Gram-Negative Bacteria, Gram-Negative Bacterial Infections, Hospitals, Humans, Microbial Sensitivity Tests, Microbiology (medical), Infectious Diseases, biology, Microbial Sensitivity Test, Bacterial, antibiotic management, carbapenem-resistant Gram-negative bacteria, General Medicine, 3. Good health, medicine.drug, Human, medicine.medical_specialty, medicine.drug_class, 030106 microbiology, Fosfomycin, carbapenem-resistant Gram-negative bacteria, 03 medical and health sciences, Hospital, Internal medicine, Anti-Bacterial Agent, medicine, Gram-Negative Bacterial Infection, Cross-Sectional Studie, business.industry, biochemical phenomena, metabolism, and nutrition, biology.organism_classification, bacterial infections and mycoses, Infectious disease (medical specialty), Carbapenem-resistant gram-negative bacilli, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, antibiotic management, business, Rifampicin
Abstract

ESGAP, ESGBIS, ESGIE and the CRGNB treatment survey study group., [Objectives] To explore contemporary antibiotic management of infections caused by carbapenem-resistant Gram-negative bacteria in hospitals., [Methods] Cross-sectional, internet-based questionnaire survey. We contacted representatives of all hospitals with more than 800 acute-care hospital beds in France, Greece, Israel, Italy, Kosovo, Slovenia, Spain and selected hospitals in the USA. We asked respondents to describe the most common actual practice at their hospital regarding management of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa through close-ended questions., [Results] Between January and June 2017, 115 of 141 eligible hospitals participated (overall response rate 81.6%, country-specific rates 66.7%–100%). Most were tertiary-care (99/114, 86.8%), university-affiliated (110/115, 89.1%) hospitals and most representatives were infectious disease specialists (99/115, 86.1%). Combination therapy was prescribed in 114/115 (99.1%) hospitals at least occasionally. Respondents were more likely to consider combination therapy when treating bacteraemia, pneumonia and central nervous system infections and for Enterobacteriaceae, P. aeruginosa and A. baumannii similarly. Combination of a polymyxin with a carbapenem was used in most cases, whereas combinations of a polymyxin with tigecycline, an aminoglycoside, fosfomycin or rifampicin were also common. Monotherapy was used for treatment of complicated urinary tract infections, usually with an aminoglycoside or a polymyxin. The intended goal of combination therapy was to improve the effectiveness of the treatment and to prevent development of resistance. In general, respondents shared the misconception that combination therapy is supported by strong scientific evidence., [Conclusions] Combination therapy was the preferred treatment strategy for infections caused by carbapenem-resistant Gram-negative bacteria among hospital representatives, even though high-quality evidence for carbapenem-based combination therapy is lacking., EDM received funding by NIH for project HHSN272201000039C. JRB received funding for research from Plan Nacional de I + D + i 2013–2016 and Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Economía, Industria y Competitividad, Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0001)—co-financed by European Development Regional Fund A way to achieve Europe, Operative Programme Intelligent Growth 2014–2020.

Published
2018

45. Antimicrobial Use in Hospitalised Patients with COVID-19: An International Multicentre Point-Prevalence Study

Author

Lea Papst, Roberto Luzzati, Biljana Carević, Carlo Tascini, Nina Gorišek Miksić, Vera Vlahović Palčevski, Zorana M. Djordjevic, Omar Simonetti, Emanuela Sozio, Milica Lukić, Goran Stevanović, Davor Petek, Bojana Beović, Papst, L., Luzzati, R., Carevic, B., Tascini, C., Miksic, N. G., Palcevski, V. V., Djordjevic, Z. M., Simonetti, O., Sozio, E., Lukic, M., Stevanovic, G., Petek, D., and Beovic, B.

Subjects
Microbiology (medical), multicentre, point-prevalence study, COVID-19, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Infectology, antimicrobial use, Biochemistry, Microbiology, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Klinička farmakologija s toksikologijom, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Clinical Pharmacology and Toxicology, Point-prevalence study, Antimicrobial use, Infectious Diseases, Multicentre, Pharmacology (medical), General Pharmacology, Toxicology and Pharmaceutics, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Infektologija
Abstract

Studies suggest that the incidence of coinfections in patients with the coronavirus disease 2019 (COVID-19) is low, but a large number of patients receive antimicrobials during hospitalisation. This may fuel a rise in antimicrobial resistance (AMR). We conducted a multicentre point-prevalence survey in seven tertiary university hospitals (in medical wards and intensive care units) in Croatia, Italy, Serbia and Slovenia. Of 988 COVID-19 patients, 521 were receiving antibiotics and/or antifungals (52.7%; range across hospitals: 32.9–85.6%) on the day of the study. Differences between hospitals were statistically significant (χ2 (6, N = 988) = 192.57, p < 0.001). The majority of patients received antibiotics and/or antifungals within 48 h of admission (323/521, 62%; range across hospitals: 17.4–100%), their most common use was empirical (79.4% of prescriptions), and pneumonia was the main indication for starting the treatment (three-quarters of prescriptions). The majority of antibiotics prescribed (69.9%) belonged to the “Watch” group of the World Health Organization AWaRe classification. The pattern of antimicrobial use differed across hospitals. The data show that early empiric use of broad-spectrum antibiotics is common in COVID-19 patients, and that the pattern of antimicrobial use varies across hospitals. Judicious use of antimicrobials is warranted to prevent an increase in AMR.

Published
2022

46. Neuraminidase Inhibitors and Hospital Length of Stay: A Meta-analysis of Individual Participant Data to Determine Treatment Effectiveness Among Patients Hospitalized With Nonfatal 2009 Pandemic Influenza A(H1N1) Virus Infection

Author

Venkatesan, Sudhir, Myles, Puja R, Bolton, Kirsty J, Muthuri, Stella G, Al Khuwaitir, Tarig, Anovadiya, Ashish P, Azziz-Baumgartner, Eduardo, Bajjou, Tahar, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H, Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Chinbayar, Tserendorj, Cilloniz, Catia, Denholm, Justin T, Dominguez, Samuel R, Duarte, Pericles A D, Dubnov-Raz, Gal, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath Lorena, Hoeger, Peter H, Hu, Xiao Yun, Islam, Quazi T, Jiménez, Mirela F, Keijzers, Gerben, Khalili, Hossein, Kusznierz, Gabriela, Kuzman, Ilija, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Libster, Romina P, Linko, Rita, Madanat, Faris, Maltezos, Efstratios, Mamun, Abdullah, Manabe, Toshie, Metan, Gokhan, Mickiene, Auksė, Mikić, Dragan, Mohn, Kristin G I, Oliva, Maria E, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Rath, Barbara A, Refaey, Samir, Rodríguez, Alejandro H, Sertogullarindan, Bunyamin, Skręt-Magierło, Joanna, Somer, Ayper, Talarek, Ewa, Tang, Julian W, To, Kelvin, Tran, Dat, Uyeki, Timothy M, Vaudry, Wendy, Vidmar, Tjasa, Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan S, PRIDE Consortium Investigators, Imperial College London, HUS Perioperative, Intensive Care and Pain Medicine, Department of Diagnostics and Therapeutics, Clinicum, Venkatesan S., Myles P.R., Bolton K.J., Muthuri S.G., Al Khuwaitir T., Anovadiya A.P., Azziz-Baumgartner E., Bajjou T., Bassetti M., Beovic B., Bertisch B., Bonmarin I., Booy R., Borja-Aburto V.H., Burgmann H., Cao B., Carratala J., Chinbayar T., Cilloniz C., Denholm J.T., Dominguez S.R., Duarte P.A.D., Dubnov-Raz G., Fanella S., Gao Z., Gerardin P., Giannella M., Gubbels S., Herberg J., Higuera Iglesias A.L., Hoeger P.H., Hu X.Y., Islam Q.T., Jimenez M.F., Keijzers G., Khalili H., Kusznierz G., Kuzman I., Langenegger E., Lankarani K.B., Leo Y.-S., Libster R.P., Linko R., Madanat F., Maltezos E., Mamun A., Manabe T., Metan G., Mickiene A., Mikic D., Mohn K.G.I., Oliva M.E., Ozkan M., Parekh D., Paul M., Rath B.A., Refaey S., Rodriguez A.H., Sertogullarindan B., Skret-Magierlo J., Somer A., Talarek E., Tang J.W., To K., Tran D., Uyeki T.M., Vaudry W., Vidmar T., Zarogoulidis P., and Nguyen-Van-Tam J.S.

Subjects
0301 basic medicine, Male, pandemic influenza, OSELTAMIVIR TREATMENT, IMPACT, Neuraminidase/antagonists & inhibitors, CHILDREN, medicine.disease_cause, 0302 clinical medicine, antivirals, Influenza A Virus, H1N1 Subtype, Adrenal Cortex Hormones, IPD meta-analysi, Influenza A virus, Immunology and Allergy, 030212 general & internal medicine, IPD meta-analysis, Young adult, Enzyme Inhibitors, Child, 11 Medical and Health Sciences, RISK, 11832 Microbiology and virology, Antiviral Agents/therapeutic use, OUTCOMES, COMPLICATIONS, biology, Neuraminidase inhibitor, Enzyme inhibitors, Middle Aged, Antivirals, antiviral, 3. Good health, Anti-Bacterial Agents, Infectious Diseases, Treatment Outcome, Meta-analysis, Cohort, Viruses, Enzyme Inhibitors/pharmacology/therapeutic use, Female, Pandemic influenza, Adult, medicine.medical_specialty, Adolescent, medicine.drug_class, 030106 microbiology, IPD meta-analysis, Neuraminidase inhibitors, antivirals, length of stay, pandemic influenza, Neuraminidase, Adrenal Cortex Hormones/therapeutic use, Microbiology, Antiviral Agents, PRIDE Consortium Investigators, Grip, 03 medical and health sciences, Major Articles and Brief Reports, Young Adult, Pharmacotherapy, Internal medicine, Influenza, Human, medicine, Humans, COHORT, Pandemics, ddc:613, Aged, Neuraminidase inhibitors, business.industry, CLINICAL-FEATURES, ADULTS, 06 Biological Sciences, Influenza, Human/drug therapy/epidemiology, Length of Stay, Confidence interval, Influenza, Editor's Choice, Anti-Bacterial Agents/therapeutic use, Inhibidors enzimàtics, 3121 General medicine, internal medicine and other clinical medicine, biology.protein, business, RESISTANCE
Abstract

Background The effect of neuraminidase inhibitor (NAI) treatment on length of stay (LoS) in patients hospitalized with influenza is unclear. Methods We conducted a one-stage individual participant data (IPD) meta-analysis exploring the association between NAI treatment and LoS in patients hospitalized with 2009 influenza A(H1N1) virus (A[H1N1]pdm09) infection. Using mixed-effects negative binomial regression and adjusting for the propensity to receive NAI, antibiotic, and corticosteroid treatment, we calculated incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Patients with a LoS of, We found that neuraminidase inhibitor (NAI) treatment initiated on hospital admission to patients with clinically diagnosed or laboratory-confirmed A(H1N1)pdm09 virus infection was associated with a reduction in hospital length of stay when compared to later or no NAI treatment.

Published
2018

47. Antimicrobial Stewardship: From Bedside to Theory. Thirteen Examples of Old and More Recent Strategies from Everyday Clinical Practice

Author

Stefano Di Bella, Roberto Luzzati, Michael Valentini, Bojana Beović, Massimiliano Fabbiani, Di Bella, S., Beovic, B., Fabbiani, M., Valentini, M., and Luzzati, R.

Subjects
0301 basic medicine, Microbiology (medical), medicine.medical_specialty, medicine.drug_class, 030106 microbiology, Antibiotics, Psychological intervention, Review, Antimicrobial stewardship, Biochemistry, Microbiology, 03 medical and health sciences, 0302 clinical medicine, Antibiotic resistance, Antibiotic optimization, Antibiotic policy, Anti-bacterial agents, Outpatients, medicine, Oral route, Pharmacology (medical), 030212 general & internal medicine, General Pharmacology, Toxicology and Pharmaceutics, Intensive care medicine, business.industry, lcsh:RM1-950, Anti-bacterial agent, Parenteral antibiotic, Antimicrobial, Clinical Practice, lcsh:Therapeutics. Pharmacology, Infectious Diseases, business
Abstract

“Antimicrobial stewardship” is a strategy that promotes the responsible use of antimicrobials. The objective of this paper is to focus on consolidated and more recent improvements in clinical strategies that should be adopted in hospitalized patients to ameliorate their infectious diseases’ outcome and to reduce the antibiotic resistance risk through judicious use of antibiotics. We present 13 common clinical scenarios, the respective suggested interventions and the explanations of the supporting evidence, in order to help clinicians in their decision-making process. Strategies including the choice of antibiotic and dose optimization, antibiotic spectrum narrowing (de-escalation), shortening of duration, shift to oral route or outpatient parenteral antibiotic (including elastomeric pumps), and biomarkers are described and discussed.

Published
2020

48. A Global Declaration on Appropriate Use of Antimicrobial Agents across the Surgical Pathway

Author

Sartelli, M., Kluger, Y., Ansaloni, L., Carlet, J., Brink, A., Hardcastle, T. C., Khanna, A., Chicom-Mefire, A., Rodríguez-Baño, J., Nathwani, D., Mendelson, M., Watkins, R. R., Pulcini, C., Beović, B., May, A. K., Itani, K. M. F., Mazuski, J. E., Fry, D. E., Coccolini, F., Rasxa, K., Montravers, P., Eckmann, C., Abbo, L. M., Abubakar, S., Abu-Zidan, F. M., Adesunkanmi, A. K., Al-Hasan, M. N., Althani, A. A., Ticas, J. E. A., Ansari, S., Ansumana, R., Da Silva, A. R. A. , Augustin, G. , Bala, M. , Balogh, Z. J. , Baraket, O. , Bassetti, M. , Bellanova, G. , Beltran, M. A. , Ben-Ishay, O. , Boermeester, M. A. , Brecher, S. M. , Bueno, J. , Cainzos, M. A. , Cairns, K. , Camacho-Ortiz, A. , Ceresoli, M. , Chandy, S. J. , Cherry-Bukowiec, J. R. , Cirocchi, R. , Colak, E. , Corcione, A. , Cornely, O. A. , Cortese, F. , Cui, Y. , Curcio, D. , Damaskos, D. , Dasx, K. , Delibegovic, S. , Demetrashvili, Z. be, De Simone, B. bf, De Souza, H. P. bg, De Waele, J. bh, Dhingra, S. bi, Diaz, J. J. bj, Di Carlo, I. bk, Di Marzo, F. bl, DI TOMASO, SAVERIO, S. , Dogjani, A. , Dorj, G. , Dortet, L. , Duane, T. M. , Dupont, H. , Egiev, V. N. , Eid, H. O. , Elmangory, El-Sayed Marei, H. , Enani, M. A. , Escandón-Vargas, K. , Faro, M. P. , J.r., Ferrada, P., Foghetti, D., Foianini, E., Fraga, G. P., Frattima, S., Gandhi, C., Gattuso, G., Giamarellou, E., Ghnnam, W., Gkiokas, G., Girardis, M., Goff, D. A., Gomes, C. A., Gomi, H., Gronerth, R. I. G., Guirao, X., Guzman-Blanco, M., Haque, M., Hecker, A., Hell, M., Herzog, T., Hicks, L., Kafka-Ritsch, R., Kao, L. S., Kanj, S. S., Kaplan, L. J., Kapoor, G., Karamarkovic, A., Kashuk, J., Kenig, J., Khamis, F., Khokha, V., Kiguba, R., Kirkpatrick, A. W., Kørner, H., Koike, K., Kok, K. Y. Y., Kon, K., Kong, V., Inaba, K., Ioannidis, O., Isik, A., Iskandar, K., Labbate, M., Labricciosa, F. M., Lagrou, K., Lagunes, L., Latifi, R., Lasithiotakis, K., Laxminarayan, R., Lee, J. G., Leone, M., Leppäniemi, A., Li, Y., Liang, S. Y., Liau, K. -.H., Litvin, A., Loho, T., Lowman, W., Machain, G. Mf, Maier, R. V., Manzano-Nunez, R., Marinis, A., Marmorale, C., Martin-Loeches, I., Marwah, S., Maseda, E., McFarlane, M., BEZERRA DE MELO PEREIRA NUNES, CINTIA, R. , Melotti, R. , Memish, Z. , Mertz, D. , Mesina, C. , Menichetti, F. , Mishra, S. K. , Montori, G. , Moore, E. E. , Moore, F. A. , Naidoo, NAPOLITANO, NELLO, L. , Negoi, I. , Nicolau, D. P. , Nikolopoulos, I. , Nord, C. E. , Ofori-Asenso, R. , Olaoye, I. , Omari, A. H. , Ordoñez, C. A. , Ouadii, M. , Ouedraogo, A. , Pagani, L. , Paiva, J. A. , Parreira, J. G. , Pata, F. fm, Pereira, J., Pereira, N. R., Petrosillo, N., Picetti, E., Pintar, T., Ponce-De-Leon, A., Popovski, Z., Poulakou, G., Preller, J., Guerrero, A. P., Pupelis, G., Quiodettis, M., Rawson, T. M., Reichert, M., Reinhart, K., Rems, M., Rello, J., Rizoli, S., ROBERTS, HENRI JOHAN EDUARD, Rubio-Perez, I., Ruppé, E., Sakakushev, B., Sall, I., Kafil, H. S. j, Sanders, J., Sato, N., Sawyer, R. G., T. , Scibé, R. , Scudeller, L. , Lohse, H. S. , Sganga, G. , Shafiq, N. , Shah, J. N. , Spigaglia, P. , Suroowan, S. , Tsioutis, C. , Sifri, C. D. , Siribumrungwong, B. , Sugrue, M. , Talving, P. , Tan, B. K. , Tarasconi, A. , Tascini, C. , Tilsed, J. , Timsit, J. -.F. , Tumbarello, M. , Trung, N. T. , Ulrych, J. , Uranues, S. , Velmahos, G. , Vereczkei, A. G. , Viale, P. , Estape, J. V. , Viscoli, C. , Wagenlehner, F. , Wright, B. J. , Xiao, Y. , Yuan, K. -.C. , Zachariah, S. K. , Zahar, J. R. , Mergulhão, P. , Catena, Réanimation Médico-Chirurgicale, Groupe Hospitalier Paris Saint-Joseph, University Hospital Virgen Macarena, Internal Medicine Department, Universidad de Sevilla, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA), Service d'anesthésie - réanimation chirurgicale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Klinik I für Innere Medizin und Zentrum für Klinische Studien (ZKS) 01KN0706, Universitätsklinikum Köln (Uniklinik Köln), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), CHU Amiens-Picardie, Paracelsus Medizinische Privatuniversität = Paracelsus Medical University (PMU), Université Catholique de Louvain = Catholic University of Louvain (UCL), Center for Disease Dynamics, Economics & Policy (CDDEP), Unité de Recherche sur les Maladies Infectieuses Tropicales Emergentes (URMITE), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Hartford Hospital, Department of Laboratory Medicine, Karolinska Institutet [Stockholm], Pathogénèse et contrôle des infections chroniques (PCCI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Instituto Nacional de Matemática Pura e Aplicada (IMPA), Instituto Nacional de matematica pura e aplicada, 4th Department of Internal Medicine, ATTIKON University General Hospital, Department of Anesthesiology and Intensive Care, Friedrich-Schiller-Universität = Friedrich Schiller University Jena [Jena, Germany], Critical Care Department, Joan XXIII University Hospital, Departmet of Infectious, Parasitic and Immune-Mediated Disease, Istituto Superiore di Sanita [Rome], Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), Department of Internal Medicine, Geriatrics and Nephrologic Diseases, Section of Infectious Diseases, S.Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna (UNIBO), Infectious Diseases, University of Genoa (UNIGE), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Groupe Hospitalier Paris Saint-Joseph (hpsj), Universidad de Sevilla / University of Sevilla, Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Nice Sophia Antipolis (1965 - 2019) (UNS), Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Istituto Superiore di Sanità (ISS), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Università degli studi di Genova = University of Genoa (UniGe), Sartelli, Massimo, Kluger, Yoram, Ansaloni, Luca, Carlet, Jean, Dorj, Gereltuya, Catena, Fausto, [Sartelli, Massimo] Macerata Hosp, Dept Surg, Macerata, Italy, [Scibe, Rodolfo] Macerata Hosp, Dept Surg, Macerata, Italy, [Kluger, Yoram] Rambam Hlth Care Campus, Dept Gen Surg, Div Surg, Haifa, Israel, [Ben-Ishay, Ofir] Rambam Hlth Care Campus, Dept Gen Surg, Div Surg, Haifa, Israel, [Ansaloni, Luca] Papa Giovanni XXIII Hosp, Gen Surg Dept, Bergamo, Italy, [Coccolini, Federico] Papa Giovanni XXIII Hosp, Gen Surg Dept, Bergamo, Italy, [Ceresoli, Marco] Papa Giovanni XXIII Hosp, Gen Surg Dept, Bergamo, Italy, [Montori, Giulia] Papa Giovanni XXIII Hosp, Gen Surg Dept, Bergamo, Italy, [Carlet, Jean] World Alliance Antibiot Resistance, Paris, France, [Brink, Adrian] Milpark Hosp, Ampath Natl Lab Serv, Dept Clin Microbiol, Johannesburg, South Africa, [Brink, Adrian] Univ Cape Town, Dept Med, Div Infect Dis & HIV Med, Cape Town, South Africa, [Hardcastle, Timothy C.] Inkosi Albert Luthuli Cent Hosp, Trauma Serv, Durban, South Africa, [Hardcastle, Timothy C.] Nelson R Mandela Sch Clin Med, Dept Surg, Durban, South Africa, [Khanna, Ashish] Ctr Crit Care, Anaesthesiol Inst, Cleveland, OH USA, [Khanna, Ashish] Cleveland Clin, Dept Outcomes Res, Cleveland, OH 44106 USA, [Chicom-Mefire, Alain] Univ Buea, Dept Surg & Obstet Gynaecol, Buea, Cameroon, [Foianini, Esteban] Univ Buea, Dept Surg & Obstet Gynaecol, Buea, Cameroon, [Rodriguez-Bano, Jesus] Hosp Univ Virgen Macarena & Virge del Rocio IbiS, Unidad Clin Interctr Enfermedades Infecciosas Mic, Seville, Spain, [Rodriguez-Bano, Jesus] Univ Seville, Dept Med, Seville, Spain, [Nathwani, Dilip] Ninewells Hosp & Med Sch, Dundee, Scotland, [Mendelson, Marc] Univ Cape Town, Groote Schuur Hosp, Dept Med, Div Infect Dis & HIV Med, Cape Town, South Africa, [Watkins, Richard R.] Cleveland Clin Akron Gen, Div Infect Dis, Akron, OH USA, [Watkins, Richard R.] Northeast Ohio Med Univ, Rootstown, OH USA, [Pulcini, Celine] Lorraine Univ, EA APEMAC 4360, Nancy, France, [Pulcini, Celine] Nancy Univ Hosp, Infect Dis Dept, Nancy, France, [Beovic, Bojana] Univ Med Ctr Ljubljana, Ljubljana, Slovenia, [Beovic, Bojana] Univ Ljubljana, Fac Med, Ljubljana, Slovenia, [May, Addison K.] Vanderbilt Univ, Med Ctr, Div Trauma & Surg Crit Care, Nashville, TN USA, [Itani, Kamal M. F.] Boston Univ, Dept Surg, VA Boston Hlth Care Syst, Boston, MA 02215 USA, [Itani, Kamal M. F.] Harvard Med Sch, Boston, MA USA, [Mazuski, John E.] Washington Univ, Sch Med, Dept Surg, St Louis, MO 63110 USA, [Fry, Donald E.] Northwestern Univ, Feinberg Sch Med, Dept Surg, Chicago, IL 60611 USA, [Fry, Donald E.] Univ New Mexico, Sch Med, Albuquerque, NM 87131 USA, [Rasa, Kemal] Anadolu Med Ctr, Dept Surg, Kocaali, Turkey, [Montravers, Philippe] Bichat Claude Bernard Univ Hosp, Paris Diderot Sorbonne Cite Univ, Anesthesiol & Crit Care Med, HUPNSV, Paris, France, [Eckmann, Christian] Hannover Med Sch, Acad Hosp, Dept Gen Visceral & Thorac Surg, Peine, Germany, [Abbo, Lilian M.] Univ Miami, Miller Sch Med, Jackson Hlth Syst, Div Infect Dis, Miami, FL 33136 USA, [Abbo, Lilian M.] Bayero Univ, Dept Nursing Sci, Kano, Nigeria, [Abubakar, Salisu] UAE Univ, Coll Med & Hlth Sci, Dept Surg, Al Ain, U Arab Emirates, [Abu-Zidan, Fikri M.] Obafemi Awolowo Univ, Coll Hlth Sci, Dept Surg, Ife, Nigeria, [Al-Hasan, Majdi N.] Univ South Carolina, Sch Med, Dept Med, Div Infect Dis, Columbia, SC USA, [Althani, Asma A.] Qatar Univ, Biomed Res Ctr, Doha, Qatar, [Marei, Hany El-Sayed] Qatar Univ, Biomed Res Ctr, Doha, Qatar, [Ticas, Jorge Eduardo Alvarenga] Hosp Nacl Ros, Emergency Unit, San Salvador, El Salvador, [Ansari, Shamshul] Oita Univ, Dept Environm & Prevent Med, Fac Med, Oita, Japan, [Ansari, Shamshul] Chitwan Med Coll, Dept Microbiol, Bharatpur, Nepal, [Ansumana, Rashid] Univ Liverpool, Liverpool Sch Trop Med, Ctr Neglected Trop Dis, Bo, Sierra Leone, [Ansumana, Rashid] Njala Univ, Mercy Hosp, Res Lab, Bo, Sierra Leone, [Araujo da Silva, Andre Ricardo] Prontobaby Hosp Crianca, Infect Control Comm, Rio De Janeiro, Brazil, [Augustin, Goran] Univ Hosp Ctr, Dept Surg, Zagreb, Croatia, [Bala, Miklosh] Hadassah Hebrew Univ Med Ctr, Trauma & Acute Care Surg Unit, Jerusalem, Israel, [Balogh, Zsolt J.] John Hunter Hosp, Dept Traumatol, Newcastle, NSW, Australia, [Balogh, Zsolt J.] Univ Newcastle, Newcastle, NSW, Australia, [Baraket, Oussema] Bizerte Hosp, Dept Surg, Bizerte, Tunisia, [Bassett, Matteo] Santa Maria Misericordia Univ Hosp, Infect Dis Div, Udine, Italy, [Bellanova, Giovanni] SS Annunziata Hosp, Dept Surg, Taranto, Italy, [Beltran, Marcelo A.] Hosp San Juan Dios, Dept Gen Surg, La Serena, Chile, [Biffl, Walter L.] Queens Med Ctr, Acute Care Surg, Honolulu, HI USA, [Boermeester, Marja A.] Acad Med Ctr, Dept Surg, Amsterdam, Netherlands, [Brecher, Stephen M.] Boston Univ, Sch Med, VA Boston HealthCare Syst, Dept Pathol & Lab Med, Boston, MA 02118 USA, [Brecher, Stephen M.] Boston Univ, Sch Med, Dept Pathol & Lab Med, Boston, MA 02118 USA, [Bueno, Juan] Fdn Ctr Invest Bioprospecc & Biotecnol Biodivers, Barranquilla, Colombia, [Cainzos, Miguel A.] Hosp Clin Univ, Dept Surg, Santiago De Compostela, Spain, [Cairns, Kelly] Alfred Hlth, Pharm Dept, Melbourne, Vic, Australia, [Camacho-Ortiz, Adrian] Hosp Univ Dr Jose Eleuterio Gonzalez, Hosp Epidemiol & Infect Dis, Monterrey, Mexico, [Chandy, Sujith J.] Christian Med Coll & Hosp, Dept Pharmacol & Clin Pharmacol, Vellore, Tamil Nadu, India, [Cherry-Bukowiec, Jill R.] Univ Michigan, Dept Surg, Div Acute Care Surg, Ann Arbor, MI 48109 USA, [Cirocchi, Roberto] Univ Perugia, Dept Gen & Oncol Surg, Terni, Italy, [Colak, Elif] Hlth Sci Univ, Samsun Training & Res Hosp, Dept Gen Surg, Samsun, Turkey, [Corcione, Antonio] AORN Colli Vincenzo Monaldi Hosp, Anesthesia & Intens Care Unit, Naples, Italy, [Cornely, Oliver A.] Univ Cologne, German Ctr Infect Res DZIF, Dept Internal Med 1, Cologne Excellence Cluster Cellular Stress Respon, Cologne, Germany, [Cortese, Francesco] San Filippo Neris Hosp, Emergency Surg Unit, Rome, Italy, [Cui, Yunfeng] Tianjin Med Univ, Tianjin Nankai Hosp, Dept Surg, Nankai Clin Sch Med, Tianjin, Peoples R China, [Curcio, Daniel] Buenos Aires Univ, Infectol Inst SRL, Buenos Aires, DF, Argentina, [Damaskos, Dimitris] Royal Infirm Edinburgh NHS Trust, Dept Surg, Edinburgh, Midlothian, Scotland, [Das, Koray] Ankara Numune Training & Res Hosp, Dept Surg, Adana, Turkey, [Delibegovic, Samir] Univ Clin Ctr Tuzla, Dept Surg, Tuzla, Bosnia & Herceg, [Deme-Trashvili, Zaza] Kipshidze Cent Univ Hosp, Dept Gen Surg, Tbilisi, Georgia, [De Simone, Belinda] Cannes Hosp, Dept Digest Surg, Cannes, France, [de Souza, Hamilton Petry] Pontificia Univ Catolica Rio Grande do Sul PUCRS, Sch Med, Dept Surg, Porto Alegre, RS, Brazil, [De Waele, Jan] Ghent Univ Hosp, Dept Crit Care Med, Ghent, Belgium, [Dhingra, Sameer] Univ West Indies, Eric Williams Med Sci Complex, Sch Pharm, Fac Med Sci, Uriah Butler Highway, Champ Fleurs, Trinidad Tobago, [Diaz, Jose J.] Univ Maryland, R Adams Cowley Shock Trauma Ctr, Div Acute Care Surg, Program Trauma, Baltimore, MD 21201 USA, [Di Carlo, Isidoro] Univ Catania, Cannizzaro Hosp, Dept Surg Sci, Catania, Italy, [Di Marzo, Francesco] Versilia Hosp, Gen Surg, Usl Nordovest, Tuscany, Italy, [Di Saverio, Salomone] Maggiore Hosp, Dept Surg, Bologna, Italy, [Dogjani, Agron] Univ Hosp Trauma, Dept Surg, Tirana, Albania, [Dorj, Gereltuya] Mongolian Natl Univ Med Sci, Sch Pharm, Ulaanbaatar, Mongolia, [Dortet, Laurent] Paris Sud Univ, Bicetre Hosp, Dept Microbiol, La Kremlin Bicetre, France, [Duane, Therese M.] John Peter Smith Hlth Network, Dept Surg, Ft Worth, TX USA, [Dupont, Herve] Univ Picardie Jules Verne, CHU Amiens Picardie, Dept Anesthesie Reanimat, Amiens, France, [Dupont, Herve] Univ Picardie Jules Verne, INSERM, U1088, Amiens, France, [Egiev, Valery N.] Pirogov Russian Natl Res Med Univ, Dept Surg, Moscow, Russia, [Eid, Hani O.] Al Ain Hosp, Mediclin Middle East, Dept Emergency Med, Al Ain, U Arab Emirates, [Elmangory, Mutasim] Fed Minist Hlth, Sudan Natl Publ Hlth Lab, Khartoum, Sudan, [Enani, Mushira Abdulaziz] King Fahad Med City, Div Infect Dis, Dept Med, Riyadh, Saudi Arabia, [Escandon-Vargas, Kevin] Univ Valle, Escuela Med, Fac Salud, Cali, Colombia, [Faro Junior, Mario P.] ABC Med Sch, Dept Gen Surg Trauma, Santo Andre, SP, Brazil, [Faro Junior, Mario P.] ABC Med Sch, Emergency Surg Div, Santo Andre, SP, Brazil, [Ferrada, Paula] Virginia Commonwealth Univ, Dept Surg, Richmond, VA USA, [Foghetti, Domitilla] Pesaro Hosp, Dept Surg, Pesaro, Italy, Clin Foianini, Dept Surg, Santa Cruz, Bolivia, [Fraga, Gustavo P.] Univ Campinas Unicamp, Sch Med Sci, Dept Surg, Div Trauma Surg, Campinas, SP, Brazil, [Frattima, Sabrina] Ist Clin San Rocco Franciacorta, Brescia, Italy, [Gandhi, Chinmay] Bharati Vidyapeeth Deemed Univ Med Coll & Hosp, Dept Surg, Sangli, Maharashtra, India, [Gattuso, Gianni] C Poma Hosp, Infect Dis Dept, Mantua, Italy, [Giamarellou, Eleni] Hygeia Gen Hosp, Dept Internal Med 6, Athens, Greece, [Ghnnam, Wagih] Mansoura Univ, Mansoura Fac Med, Dept Gen Surg, Mansoura, Egypt, [Gkiokas, George] Natl & Kapodistrian Univ Athens, Aretaieion Univ Hosp, Dept Surg 2, Athens, Greece, [Girardis, Massimo] Modena Univ Hosp, Intens Care Unit, Modena, Italy, [Goff, Debbie A.] Ohio State Univ, Wexner Med Ctr, Columbus, OH 43210 USA, [Gomes, Carlos Augusto] Hosp Univ Terezinha Jesus, Dept Surg, Fac Ciencias Med & Saude Juiz de Fora, Juiz De Fora, Brazil, [Gomi, Harumi] Univ Tsukuba, Mito Kyodo Gen Hosp, Ctr Global Hlth, Mito, Ibaraki, Japan, [Guerra Gronerth, Rosio Isabel] Peruvian Navy Med Ctr, Lima, Peru, [Guirao, Xavier] Parc Tauli Univ Hosp, Dept Gen Surg, Unit Endocrine Head & Neck Surg, Sabadell, Spain, [Guirao, Xavier] Parc Tauli Univ Hosp, Dept Gen Surg, Unit Surg Infect Support, Sabadell, Spain, [Guzman-Blanco, Manuel] Hosp Privado Ctr Med Caracas, Caracas, Venezuela, [Guzman-Blanco, Manuel] Hosp Vargas Caracas, Caracas, Venezuela, [Haque, Mainul] Univ Pertahanan Nasional Malaysia, Natl Def Univ Malaysia, Unit Pharmacol, Fac Med & Def Hlth, Kuala Lumpur, Malaysia, [Reichert, Martin] Univ Pertahanan Nasional Malaysia, Natl Def Univ Malaysia, Unit Pharmacol, Fac Med & Def Hlth, Kuala Lumpur, Malaysia, [Hecker, Andreas] Univ Hosp Giessen, Dept Gen & Thorac Surg, Giessen, Germany, [Hell, Markus] Paracelsus Med Univ, Acad Teaching Lab, Clin Microbiol & Infect Control, MEDILAB Dr Mustafa Dr Richter OG, Salzburg, Austria, [Herzog, Torsten] Ruhr Univ Bochum, St Josef Hosp, Dept Surg, Bochum, Germany, [Hicks, Lauri] Ctr Dis Control & Prevent, Div Healthcare Qual Promot, Atlanta, GA USA, [Kafka-Ritsch, Reinhold] Innsbruck Med Univ, Dept Visceral Transplant & Thorac Surg, Innsbruck, Austria, [Kao, Lillian S.] Univ Texas Hlth Sci Ctr Houston, Dept Surg, Houston, TX 77030 USA, [Kanj, Souha S.] Amer Univ Beirut, Dept Internal Med, Div Infect Dis, Beirut, Lebanon, [Kaplan, Lewis J.] Univ Penn, Perelman Sch Med, Philadelphia VA Med Ctr, Dept Surg, Philadelphia, PA 19104 USA, [Kapoor, Garima] Gandhi Med Coll, Dept Microbiol, Bhopal, India, [Karamarkovic, Aleksandar] Univ Belgrade, Clin Emergency Surg, Med Fac, Belgrade, Serbia, [Kashuk, Jeffry] Tel Aviv Univ, Dept Surg, Assia Med Grp, Sackler Sch Med, Tel Aviv, Israel, [Kenig, Jakub] Jagiellonian Univ, Med Coll, Dept Gen Surg 3, Krakow, Poland, [Khamis, Faryal] Royal Hosp, Dept Internal Med, Muscat, Oman, [Khokha, Vladimir] City Hosp, Dept Emergency Surg, Mozyr, BELARUS, [Kiguba, Ronald] Makerere Univ, Dept Pharmacol & Therapeut, Coll Hlth Sci, Kampala, Uganda, [Kirkpatrick, Andrew W.] Foothills Med Ctr, Gen Acute Care Abdominal Wall Reconstruct & Traum, Calgary, AB, Canada, [Korner, Hartwig] Stavanger Univ Hosp, Dept Gastrointestinal Surg, Stavanger, Norway, [Koike, Kaoru] Kyoto Univ, Grad Sch Med, Dept Primary Care & Emergency Med, Kyoto, Japan, [Kok, Kenneth Y. Y.] Brunei Canc Ctr, Dept Surg, Jerudong Pk, Jerudong, Brunei, [Kon, Kateryna] Kharkiv Natl Med Univ, Dept Microbiol Virol & Immunol, Kharkov, Ukraine, [Kong, Victor] Edendale Hosp, Dept Surg, Pietermaritzburg, South Africa, [Inaba, Kenji] Univ Southern Calif, Los Angeles Cty & Univ So Cali fornia Med Ctr, Div Acute Care Surg & Surg Crit Care, Dept Surg, Los Angeles, CA USA, [Ioannidis, Orestis] Aristotle Univ Thessaloniki, Gen Hosp G Papanikolaou, Surg Dept 4, Med Sch, Thessaloniki, Greece, [Isik, Arda] Erzincan Univ, Dept Gen Surg, Fac Med, Erzincan, Turkey, [Iskandar, Katia] Lebanese Int Univ, Dept Pharm, Beirut, Lebanon, [Labbate, Maurizio] Univ Technol Sydney, Sch Life Sci, Sydney, NSW, Australia, [Labbate, Maurizio] Univ Technol Sydney, Inst I3, Sydney, NSW, Australia, [Labricciosa, Francesco M.] UNIVPM, Dept Biomed Sci & Publ Hlth, Unit Hyg Prevent Med & Publ Hlth, Ancona, Italy, [Lagrou, Katrien] Univ Hosp Leuven, Clin Dept Lab Med, Leuven, Belgium, [Lagrou, Katrien] Katholieke Univ Leuven, Dept Microbiol & Immunol, Leuven, Belgium, [Lagunes, Leonel] Hosp Cent Dr Ignacio Morones Prieto, San Luis Potosi, Mexico, [Latifi, Rifat] Univ Arizona, Dept Surg, Div Trauma, Tucson, AZ USA, [Lasithiotakis, Kostas] York Teaching Hosp NHS Fdn Trust, Dept Surg, York, N Yorkshire, England, [Laxminarayan, Ramanan] Ctr Dis Dynam Econ & Policy, Washington, DC USA, [Lee, Jae Gil] Yonsei Univ, Coll Med, Dept Surg, Seoul, South Korea, [Leone, Marc] Aix Marseille Univ, Hop Nord, AP HM, Dept Anaesthesiol & Crit Care, Marseille, France, [Leppaniemi, Ari] Univ Hosp Meilahti, Abdominal Ctr, Helsinki, Finland, [Li, Yousheng] Shanghai Jiao Tong Univ, Sch Med, Shanghai Peoples Hosp 9, Dept Surg, Shanghai, Peoples R China, [Liang, Stephen Y.] Washington Univ, Sch Med, Div Infect Dis, Div Emergency Med, St Louis, MO USA, [Liau, Kui-Hin] Natl Univ Singapore, Mt Elizabeth Novena Hosp, Singapore & Yong Loo Lin Sch Med, Dept Surg,Liau KH Consulting, Singapore, Singapore, [Litvin, Andrey] Immanuel Kant Balt Fed Univ, Surg Disciplines, Reg Clin Hosp, Kaliningrad, Russia, [Loho, Tonny] Univ Indonesia, Cipto Mangunkusumo Gen Hosp, Dept Clin Pathol, Div Infect Dis,Fac Med, Jakarta, Indonesia, [Lowman, Warren] Univ Witwatersrand, Sch Pathol, Vermaak Partners Pathcare Pathologists, Clin Microbiol & Infect Dis,Fac Hlth Sci, Johannesburg, South Africa, [Lowman, Warren] Wits Donald Gordon Med Ctr, Johannesburg, South Africa, [Machain, Gustavo M.] Univ Nacl Asuncion, Dept Surg, Asuncion, Paraguay, [Segovia Lohse, Helmut] Univ Nacl Asuncion, Dept Surg, Asuncion, Paraguay, [Maier, Ronald V.] Univ Washington, Dept Surg, Seattle, WA 98195 USA, [Manzano-Nunez, Ramiro] Fdn Valle Lili, Clin Res Ctr, Cali, Colombia, [Marinis, Athanasios] Tzane Gen Hosp, Dept Surg 1, Piraeus, Greece, [Marmorale, Cristina] Univ Politecn Marche, Dept Surg, Ancona, Italy, [Martin-Loeches, Ignacio] St James Univ Hosp, Trin Ctr Hlth Sci, Dept Clin Med, Wellcome Trust HRB Clin Res,MICRO, Dublin, Ireland, [Marwah, Sanjay] Postgrad Inst Med Sci, Dept Surg, Rohtak, Haryana, India, [Maseda, Emilio] Hosp Univ La Paz Madrid, Serv Anestesia & Reanimac, Madrid, Spain, [McFarlane, Michael] Univ Hosp West Indies, Dept Surg Radiol, Kingston, Jamaica, [de Melo, Renato Bessa] Ctr Hosp Sao Joao, Gen Surg Dept, Porto, Portugal, [Melotti, Maria Rita] Alma Mater Studiorum Univ Bologna, Dept Med & Surg Sci, Anesthesiol & Intens Care, Bologna, Italy, [Memish, Ziad] Minist Hlth, Prince Mohamed Bin Abdulaziz Hosp, Dept Med, Infect Dis Div, Riyadh, Saudi Arabia, [Mertz, Dominik] McMaster Univ, Dept Med, Hamilton, ON, Canada, [Mertz, Dominik] McMaster Univ, Dept Clin Epidemiol & Biostat, Dept Pathol & Mol Med, Hamilton, ON, Canada, [Mesina, Cristian] Emergency Hosp Craiova, Surg Clin 2, Craiova, Romania, [Menichetti, Francesco] Univ Hosp Pisa, Infect Dis Unit, Pisa, Italy, [Mishra, Shyam Kumar] Tribhuvan Univ, Teaching Hosp, Inst Med, Dept Microbiol, Kathmandu, Nepal, [Moore, Ernest E.] Univ Colorado, Denver 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Norio] Ehime Univ, Grad Sch Med, Dept Aeromed Serv Emergency & Trauma Care, Matsuyama, Ehime, Japan, [Sawyer, Robert G.] Western Michigan Univ, Sch Med, Dept Surg, Kalamazoo, MI 49008 USA, [Scalea, Thomas] Univ Maryland, Sch Med, Dept Trauma Surg, Baltimore, MD 21201 USA, [Scudeller, Luigia] IRCCS Policlin San Matteo Fdn, Clin Epidemiol Unit, Pavia, Italy, [Sganga, Gabriele] Univ Cattolica Sacro Cuore, Policlin A Gemelli, Dept Surg, Rome, Italy, [Shafiq, Nusrat] Postgrad Inst Med Educ & Res, Dept Pharmacol, Chandigarh, India, [Shah, Jay N.] Patan Acad Hlth Sci, Dept Surg Patan Hosp, Kathmandu, Nepal, [Spigaglia, Patrizia] Ist Super Sanita, Dept Infect Dis, Rome, Italy, [Suroowan, Shanoo] Univ Mauritius, Dept Hlth Sci, Fac Sci, Reduit, Mauritius, [Tsioutis, Constantinos] European Univ Cyprus, Sch Med, Nicosia, Cyprus, [Sifri, Costi D.] Univ Virginia Hlth Syst, Off Hosp Epidemiol Infect Prevent & Control, Charlottesville, VA USA, [Siribumrungwong, Boonying] Thammasat Univ Hosp, Thammasat 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Med Univ Graz, Dept Surg, Graz, Austria, [Velmahos, George] Massachusetts Gen Hosp, Trauma Emergency Surg & Surg Crit Care, Boston, MA 02114 USA, [Vereczkei, Andras G.] Med Sch Univ Pecs, Dept Surg, Pecs, Hungary, [Viale, Pierluigi] Alma Mater Studiorum Univ Bologna, Dept Med & Surg Sci, Infect Dis Unit, Bologna, Italy, [Vila Estape, Jordi] Univ Barcelona, ISGlobal Hosp Clin, Inst Salud Global, Barcelona, Spain, [Viscoli, Claudio] Univ Genoa DISSAL, Osped Policlin San Martino IRCCS Oncol, Infect Dis Unit, Genoa, Italy, [Wagenlehner, Florian] Univ Giessen, Dept Urol Pediat Urol & Androl, Med Fac Justus Liebig, Giessen, Germany, [Wright, Brian J.] SUNY Stony Brook, Sch Med, Dept Emergency Med & Neurosurg, Stony Brook, NY 11794 USA, [Xiao, Yonghong] Zhejiang Univ, Affilliated Hosp 1, State Key Lab Diag & Treatment Infect Dis, Hangzhou, Zhejiang, Peoples R China, [Yuan, Kuo-Ching] Chang Gung Mem Hosp, Trauma & Emergency Surg Dept, Taoyuan, Taiwan, [Zachariah, Sanoop K.] MOSC Med Coll Kolenchery, Dept Surg, Cochin, Kerala, India, [Zahar, Jean Ralph] Angers Univ, CHU Angers, Infect Control Unit, Angers, France, COMBE, Isabelle, Sartelli, M, Kluger, Y, Ansaloni, L, Carlet, J, Brink, A, Hardcastle, T, Khanna, A, Chicom-Mefire, A, Rodriguez-Bano, J, Nathwani, D, Mendelson, M, Watkins, R, Pulcini, C, Beovic, B, May, A, Itani, K, Mazuski, J, Fry, D, Coccolini, F, Rasxa, K, Montravers, P, Eckmann, C, Abbo, L, Abubakar, S, Abu-Zidan, F, Adesunkanmi, A, Al-Hasan, M, Althani, A, Ticas, J, Ansari, S, Ansumana, R, Da Silva, A, Augustin, G, Bala, M, Balogh, Z, Baraket, O, Bassetti, M, Bellanova, G, Beltran, M, Ben-Ishay, O, Biffl, W, Boermeester, M, Brecher, S, Bueno, J, Cainzos, M, Cairns, K, Camacho-Ortiz, A, Ceresoli, M, Chandy, S, Cherry-Bukowiec, J, Cirocchi, R, Colak, E, Corcione, A, Cornely, O, Cortese, F, Cui, Y, Curcio, D, Damaskos, D, Dasx, K, Delibegovic, S, Demetrashvili, Z, De Simone, B, De Souza, H, De Waele, J, Dhingra, S, Diaz, J, Di Carlo, I, Di Marzo, F, Di Saverio, S, Dogjani, A, Dorj, G, Dortet, L, Duane, T, Dupont, H, Egiev, V, Eid, H, Elmangory, M, El-Sayed Marei, H, Enani, M, Escandon-Vargas, K, Faro, M, Ferrada, P, Foghetti, D, Foianini, E, Fraga, G, Frattima, S, Gandhi, C, Gattuso, G, Giamarellou, E, Ghnnam, W, Gkiokas, G, Girardis, M, Goff, D, Gomes, C, Gomi, H, Gronerth, R, Guirao, X, Guzman-Blanco, M, Haque, M, Hecker, A, Hell, M, Herzog, T, Hicks, L, Kafka-Ritsch, R, Kao, L, Kanj, S, Kaplan, L, Kapoor, G, Karamarkovic, A, Kashuk, J, Kenig, J, Khamis, F, Khokha, V, Kiguba, R, Kirkpatrick, A, Korner, H, Koike, K, Kok, K, Kon, K, Kong, V, Inaba, K, Ioannidis, O, Isik, A, Iskandar, K, Labbate, M, Labricciosa, F, Lagrou, K, Lagunes, L, Latifi, R, Lasithiotakis, K, Laxminarayan, R, Lee, J, Leone, M, Leppaniemi, A, Li, Y, Liang, S, Liau, K, Litvin, A, Loho, T, Lowman, W, Machain, G, Maier, R, Manzano-Nunez, R, Marinis, A, Marmorale, C, Martin-Loeches, I, Marwah, S, Maseda, E, Mcfarlane, M, De Melo, R, Melotti, M, Memish, Z, Mertz, D, Mesina, C, Menichetti, F, Mishra, S, Montori, G, Moore, E, Moore, F, Naidoo, N, Napolitano, L, Negoi, I, Nicolau, D, Nikolopoulos, I, Nord, C, Ofori-Asenso, R, Olaoye, I, Omari, A, Ordonez, C, Ouadii, M, Ouedraogo, A, Pagani, L, Paiva, J, Parreira, J, Pata, F, Pereira, J, Pereira, N, Petrosillo, N, Picetti, E, Pintar, T, Ponce-De-Leon, A, Popovski, Z, Poulakou, G, Preller, J, Guerrero, A, Pupelis, G, Quiodettis, M, Rawson, T, Reichert, M, Reinhart, K, Rems, M, Rello, J, Rizoli, S, Roberts, J, Rubio-Perez, I, Ruppe, E, Sakakushev, B, Sall, I, Kafil, H, Sanders, J, Sato, N, Sawyer, R, Scalea, T, Scibe, R, Scudeller, L, Lohse, H, Sganga, G, Shafiq, N, Shah, J, Spigaglia, P, Suroowan, S, Tsioutis, C, Sifri, C, Siribumrungwong, B, Sugrue, M, Talving, P, Tan, B, Tarasconi, A, Tascini, C, Tilsed, J, Timsit, J, Tumbarello, M, Trung, N, Ulrych, J, Uranues, S, Velmahos, G, Vereczkei, A, Viale, P, Estape, J, Viscoli, C, Wagenlehner, F, Wright, B, Xiao, Y, Yuan, K, Zachariah, S, Zahar, J, 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Subjects
0301 basic medicine, antibiotic agent, antifungal agent antiinfective agent, Antifungal Agents, Drug Resistance, Declaration, Inappropriate Prescribing, 030230 surgery, Global Health, Antimicrobial Stewardship, Microbial, 0302 clinical medicine, Anti-Infective Agents, Health care, Global health, Antimicrobial stewardship, Antibiotic prophylaxis, Antibiotic stewardship, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Drug Resistance, Microbial, Public relations, Antimicrobial, Operative, Anti-Bacterial Agents, Antibiotic Prophylaxis, Humans, Surgical Procedures, Operative, Surgical Wound Infection, Surgery, Microbiology (medical), Infectious Diseases, 3. Good health, surgical infections, medicine.medical_specialty, 030106 microbiology, Guidelines, 03 medical and health sciences, Antibiotic resistance, medicine, Ventilator-associated pneumonia, Adults, Surgical Procedures, business.industry, Carbapenems, Therapy, business, hospitals, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; This declaration, signed by an interdisciplinary task force of 234 experts from 83 different countries with different backgrounds, highlights the threat posed by antimicrobial resistance and the need for appropriate use of antibiotic agents and antifungal agents in hospitals worldwide especially focusing on surgical infections. As such, it is our intent to raise awareness among healthcare workers and improve antimicrobial prescribing. To facilitate its dissemination, the declaration was translated in different languages.

Published
2017

50. Hamsi scoring in the prediction of unfavorable outcomes from tuberculous meningitis: results of Haydarpasa-II study

Author

Sukran Kose, Branislava Savic, Selma Alabay, Emine Parlak, Recep Tekin, Ayhan Akbulut, Gulden Yilmaz, Haluk Vahaboglu, Nataša Popović, Özcan Deveci, Akram Al-Mahdawi, Hanefi Cem Gul, Canan Agalar, Serkan Oncu, Soline Simeon, Seniha Senbayrak, Hulya Tireli, Mehmet Bitirgen, Catalina Luca, Bahar Kandemir, Sylviane Defres, Oguz Karabay, Oğuz Reşat Sipahi, Ghaydaa A. Shehata, Alper Şener, Aysegul Ulu-Kilic, Saim Dayan, Nazif Elaldi, Mihai Nechifor, Ayşe Seza Inal, Mucahit Yemisen, Filiz Pehlivanoglu, Asuman Inan, B. Lakatos, Mustafa Namiduru, Nurgul Ceran, Muge Ozguler, Alexandru Crisan, Ahmet Karakaş, Jean-Paul Stahl, Gamze Kilicoglu, Mustafa Sunbul, Elif Sahin-Horasan, Hakan Erdem, Gorana Dragovac, Valerija Kirova, Ahmad Khalifa, Emel Yilmaz, Bruno Cacopardo, Gonul Sengoz, Hacer Deniz Ozkaya, Ebru Kurşun, Serda Gulsun, Rok Čivljak, Bojana Beović, Melanie Catroux, Oral Oncul, Isabelle Masse-Chabredier, Isik Somuncu Johansen, Katell Andre, Kadriye Kart Yaşar, Derya Ozturk-Engin, Uner Kayabas, Stéphane Chadapaud, Mehmet Parlak, Arjan Harxhi, Yves Hansmann, Ondokuz Mayıs Üniversitesi, Çukurova Üniversitesi, [Erdem, Hakan -- Oncul, Oral] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Erdem, Hakan] GATA Haydarpasa AH, Enfeksiyon Hastaliklari Servisi, Istanbul, Turkey -- [Ozturk-Engin, Derya -- Inan, Asuman -- Ceran, Nurgul -- Senbayrak, Seniha] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Tireli, Hulya] Haydarpasa Numune Training & Res Hosp, Dept Neurol, Istanbul, Turkey -- [Kilicoglu, Gamze] Haydarpasa Numune Training & Res Hosp, Dept Radiol, Istanbul, Turkey -- [Defres, Sylviane] Univ Liverpool, Inst Infect & Global Hlth, Liverpool L69 3BX, Merseyside, England -- [Defres, Sylviane] Royal Liverpool & Broadgreen Univ Hosp NHS Trust, Trop Infect Dis Unit, Liverpool, Merseyside, England -- [Gulsun, Serda] Diyarbakir Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Sengoz, Gonul -- Pehlivanoglu, Filiz] Haseki Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Crisan, Alexandru] Victor Babes Univ Med & Pharm, Dept Infect Dis, Timisoara, Romania -- [Johansen, Isik Somuncu] Odense Univ Hosp, Dept Infect Dis Q, DK-5000 Odense, Denmark -- [Nechifor, Mihai] Gr T Popa Univ Med & Pharm, Dept Pharmacol, Iasi, Romania -- [Al-Mahdawi, Akram] Baghdad Teaching Hosp, Dept Neurol, Baghdad, Iraq -- [Civljak, Rok] Univ Zagreb, Sch Med, Dr Fran Mihaljev Univ Hosp Infect Dis, Dept Infect Dis, Zagreb 41000, Croatia -- [Ozguler, Muge -- Akbulut, Ayhan] Firat Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-23169 Elazig, Turkey -- [Savic, Branislava] Univ Belgrade, Fac Med, Inst Microbiol & Immunol, Natl Reference Lab TB, Belgrade, Serbia -- [Cacopardo, Bruno] Univ Catania, Dept Clin & Mol Biomed, Infect Dis Sect, Catania, Italy -- [Inal, Ayse Seza] Cukurova Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Adana, Turkey -- [Namiduru, Mustafa] Gaziantep Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Gaziantep, Turkey -- [Dayan, Saim -- Tekin, Recep -- Deveci, Ozcan] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Kayabas, Uner] Inonu Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Malatya, Turkey -- [Parlak, Emine -- Parlak, Mehmet] Ataturk Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Khalifa, Ahmad] Damascus Hosp, Dept Neurol, Damascus, Syria -- [Kursun, Ebru] Baskent Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Adana, Turkey -- [Sipahi, Oguz Resat] Ege Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Yemisen, Mucahit] Istanbul Univ, Cerrahpasa Med Sch, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Bitirgen, Mehmet -- Kandemir, Bahar] Necmettin Erbakan Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Konya, Turkey -- [Popovic, Natasa] Clin Ctr Serbia, Clin Infect & Trop Dis, Belgrade, Serbia -- [Luca, Catalina] Gr T Popa Univ Med & Pharm, Dept Infect Dis, Iasi, Romania -- [Stahl, Jean Paul] Univ Grenoble 1, Dept Infect Dis, Grenoble, France -- [Stahl, Jean Paul] Univ Hosp Grenoble, Grenoble, France -- [Simeon, Soline] Univ Hosp Pontchaillou, Dept Infect & Trop Dis, Rennes, France -- [Ulu-Kilic, Aysegul -- Alabay, Selma] Erciyes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kayseri, Turkey -- [Yasar, Kadriye] Bakirkoy Dr Sadi Konuk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Yilmaz, Gulden] Ankara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06100 Ankara, Turkey -- [Yilmaz, Emel] Uludag Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bursa, Turkey -- [Beovic, Bojana] Univ Med Ctr, Dept Infect Dis, Ljubljana, Slovenia -- [Catroux, Melanie] Univ Poitiers Hosp, Dept Infect Dis, Poitiers, France -- [Lakatos, Botond] St Laszlo Hosp, Dept Infect Dis, Budapest, Hungary -- [Sunbul, Mustafa] Ondokuz Mayis Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Samsun, Turkey -- [Sahin-Horasan, Elif] Mersin Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Kose, Sukran] Tepecik Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Shehata, Ghaydaa] Assiut Univ Hosp, Dept Neurol & Psychiat, Assiut, Egypt -- [Andre, Katell] Dax Hosp, Dept Infect Dis, Dax, France -- [Dragovac, Gorana] Univ Novi Sad, Fac Med, IPH Vojvodina, Dept Prevent & Control Dis, Novi Sad 21000, Serbia -- [Gul, Hanefi Cem -- Karakas, Ahmet] Gulhane Mil Med Acad, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Chadapaud, Stephane] Marie Jose Treffot Hosp, Dept Infect Dis, Hyeres, France -- [Hansmann, Yves] Univ Hosp, Dept Infect Dis, Strasbourg, France -- [Harxhi, Arjan] Univ Hosp Ctr Tirana, Infect Dis Serv, Tirana, Albania -- [Kirova, Valerija] Univ Clin Infect Dis & Febrile Condit, Skopje, Macedonia -- [Masse-Chabredier, Isabelle] Aurillac Hosp, Dept Infect Dis, Aurillac, France -- [Oncu, Serkan] Adnan Menderes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Aydin, Turkey -- [Sener, Alper] Onsekiz Mart Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Canakkale, Turkey -- [Elaldi, Nazif] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Ozkaya, Hacer Deniz] Karsiyaka State Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Karabay, Oguz] Sakarya Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sakarya, Turkey -- [Agalar, Canan] Fatih Sultan Mehmet Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Vahaboglu, Haluk] Medeniyet Univ, Goztepe Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey, Inal, Ayse Seza -- 0000-0002-1182-7164, Ghaydaa, Shehata -- 0000-0002-3631-893X, Civljak, Rok -- 0000-0001-8766-7438, Karabay, Oguz -- 0000-0003-0502-432X, VAHABOGLU, Haluk -- 0000-0001-8217-1767, Karakas, Ahmet -- 0000-0002-0553-8454, Elaldi, Nazif -- 0000-0002-9515-770X, johansen, isik somuncu -- 0000-0002-2189-9823, Stahl, Jean Paul -- 0000-0002-0086-3557, Kart Yasar, Kadriye -- 0000-0003-2963-4894, Erdem, H, Ozturk-Engin, D, Tireli, H, Kilicoglu, G, Defres, S, Gulsun, S, Sengoz, G, Crisan, A, Johansen, IS, Inan, A, Nechifor, M, Al-Mahdawi, A, Civljak, R, Ozguler, M, Savic, B, Ceran, N, Cacopardo, B, Inal, AS, Namiduru, M, Dayan, S, Kayabas, U, Parlak, E, Khalifa, A, Kursun, E, Sipahi, OR, Yemisen, M, Akbulut, A, Bitirgen, M, Popovic, N, Kandemir, B, Luca, C, Parlak, M, Stahl, JP, Pehlivanoglu, F, Simeon, S, Ulu-Kilic, A, Yasar, K, Yilmaz, G, Yilmaz, E, Beovic, B, Catroux, M, Lakatos, B, Sunbul, M, Oncul, O, Alabay, S, Sahin-Horasan, E, Kose, S, Shehata, G, Andre, K, Dragovac, G, Gul, HC, Karakas, A, Chadapaud, S, Hansmann, Y, Harxhi, A, Kirova, V, Masse-Chabredier, I, Oncu, S, Sener, A, Tekin, R, Elaldi, N, Deveci, O, Ozkaya, HD, Karabay, O, Senbayrak, S, Agalar, C, Vahaboglu, H, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, and Parlak, Erkan

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, International Cooperation, Logistic regression, Sensitivity and Specificity, Severity of Illness Index, Tuberculous meningitis, Cohort Studies, Sequelae, Predictive Value of Tests, Surveys and Questionnaires, Outcome Assessment, Health Care, Severity of illness, medicine, Tuberculosis, Meningitis, Death, Outcome, Sequela, Humans, Tuberculosis, Meningitis, Death, Outcome, Sequelae, Clinical Trials as Topic, business.industry, Middle Aged, medicine.disease, Hydrocephalus, Logistic Models, Treatment Outcome, Neurology, Tuberculosis, Meningeal, Predictive value of tests, Female, Neurosciences & Neurology, Neurology (clinical), Nervous System Diseases, business, Cohort study
Abstract

WOS: 000353295400011, PubMed ID: 25634680, Predicting unfavorable outcome is of paramount importance in clinical decision making. Accordingly, we designed this multinational study, which provided the largest case series of tuberculous meningitis (TBM). 43 centers from 14 countries (Albania, Croatia, Denmark, Egypt, France, Hungary, Iraq, Italy, Macedonia, Romania, Serbia, Slovenia, Syria, Turkey) submitted data of microbiologically confirmed TBM patients hospitalized between 2000 and 2012. Unfavorable outcome was defined as survival with significant sequela or death. In developing our index, binary logistic regression models were constructed via 200 replicates of database by bootstrap resampling methodology. The final model was built according to the selection frequencies of variables. The severity scale included variables with arbitrary scores proportional to predictive powers of terms in the final model. The final model was internally validated by bootstrap resampling. A total of 507 patients' data were submitted among which 165 had unfavorable outcome. Eighty-six patients died while 119 had different neurological sequelae in 79 (16 %) patients. The full model included 13 variables. Age, nausea, vomiting, altered consciousness, hydrocephalus, vasculitis, immunosuppression, diabetes mellitus and neurological deficit remained in the final model. Scores 1-3 were assigned to the variables in the severity scale, which included scores of 1-6. The distribution of mortality for the scores 1-6 was 3.4, 8.2, 20.6, 31, 30 and 40.1 %, respectively. Altered consciousness, diabetes mellitus, immunosuppression, neurological deficits, hydrocephalus, and vasculitis predicted the unfavorable outcome in the scoring and the cumulative score provided a linear estimation of prognosis.

Published
2015

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