• Ying Guo, Wei Gao, Hongxia Yang, Cheng'en Ma, and Shujian Sui.
• Department of Intensive Care Unit, The Second Hospital of Shandong University, China.
• Heart Lung. 2016 Sep 1; 45 (5): 454-9.

ObjectiveTo evaluate the impact of de-escalation therapy on clinical outcomes in patients with severe sepsis and/or septic shock.MethodsWe performed a systematic literature search in PubMed, EMBASE, Web of Science, and CENTRAL on The Cochrane Library. The search terms used were "sepsis," "septic shock" and "de-escalation." The relative risk (RR) with 95% confidence intervals (CI) was used to evaluate the impact of de-escalation therapy on clinical outcomes.ResultsNine individual studies (1873 patients) were included. Mortality trended lower in the de-escalation group as compared with the continuation of broad-spectrum antibiotics group. However, the results were not statistically significant (RR = 0.74, 95% CI 0.54-1.03).ConclusionAntibiotic de-escalation therapy has no detrimental impact on mortality in patients with severe sepsis and/or septic shock, as compared to the continuation of broad-spectrum antibiotics. Since de-escalation affords an opportunity to limit overuse of broad-spectrum antibiotics, it should be considered as an option in clinical practice.Copyright © 2016 Elsevier Inc. All rights reserved.

19 keywords...

hide…