| Title |
De-escalating Antibiotic Use in the Inpatient Setting: Strategies, Controversies, and Challenges
|
|---|---|
| Published in |
Current Infectious Disease Reports, April 2017
|
| DOI | 10.1007/s11908-017-0575-8 |
| Pubmed ID | |
| Authors |
J. Daniel Markley, Shaina Bernard, Gonzalo Bearman, Michael P. Stevens |
| Abstract |
Antibiotic de-escalation (ADE) is widely accepted as an integral strategy to curtail the global antibiotic resistance crisis. However, there is significant uncertainty regarding the ideal ADE strategy and its true impact on antibiotic resistance. Rapid diagnostic testing has the potential to enhance ADE strategies. Herein, we aim to discuss the current strategies, controversies, and challenges of ADE in the inpatient setting. A consensus definition of ADE remains elusive at this time. Preliminary studies utilizing rapid diagnostic tests including matrix-assisted laser desorption/ionization time of flight (MALDI-TOF), procalcitonin, and other molecular techniques have demonstrated the potential to support ADE strategies. In the absence of evidence-based, highly specific ADE protocols, the likelihood that individual providers will make consistent, often challenging, decisions to de-escalate antibiotic therapy is low. Antimicrobial stewardship programs should support local physicians with ADE and develop innovative ways to integrate ADE into the broader construct of antimicrobial stewardship programs. The evolving field of rapid diagnostics has significant potential to improve ADE strategies, but more research is needed to fully realize this goal. |
X Demographics
The data shown below were collected from the profiles of 12 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 3 | 25% |
| Malaysia | 2 | 17% |
| Germany | 1 | 8% |
| Spain | 1 | 8% |
| Canada | 1 | 8% |
| Colombia | 1 | 8% |
| United Kingdom | 1 | 8% |
| Unknown | 2 | 17% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 8 | 67% |
| Scientists | 2 | 17% |
| Practitioners (doctors, other healthcare professionals) | 2 | 17% |
Mendeley readers
The data shown below were compiled from readership statistics for 51 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 51 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 9 | 18% |
| Student > Master | 8 | 16% |
| Other | 5 | 10% |
| Student > Ph. D. Student | 4 | 8% |
| Student > Postgraduate | 3 | 6% |
| Other | 11 | 22% |
| Unknown | 11 | 22% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 16 | 31% |
| Pharmacology, Toxicology and Pharmaceutical Science | 5 | 10% |
| Agricultural and Biological Sciences | 4 | 8% |
| Nursing and Health Professions | 3 | 6% |
| Veterinary Science and Veterinary Medicine | 2 | 4% |
| Other | 7 | 14% |
| Unknown | 14 | 27% |
Attention Score in Context
This research output has an Altmetric Attention Score of 7. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 11 April 2017.
All research outputs
#5,033,025
of 24,396,012 outputs
Outputs from Current Infectious Disease Reports
#105
of 505 outputs
Outputs of similar age
#84,367
of 313,505 outputs
Outputs of similar age from Current Infectious Disease Reports
#3
of 15 outputs
Altmetric has tracked 24,396,012 research outputs across all sources so far. Compared to these this one has done well and is in the 79th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 505 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.0. This one has done well, scoring higher than 79% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 313,505 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 72% of its contemporaries.
We're also able to compare this research output to 15 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 86% of its contemporaries.