Carbapenem De-escalation in urinary tract infections: prevalence and outcomes among hospitalized patients
Abstract
OBJECTIVE: To evaluate the prevalence and outcomes of carbapenem de-escalation among hospitalized urinary tract infection (UTI) patients at Jordan University Hospital from January 2022 to March 2024. METHODS: This retrospective study included adult patients who received carbapenems as empirical therapy and underwent urine culture testing. Patients who were discharged before culture results (n = 31) were excluded. The primary outcome was to assess the rate of effective de-escalation, which is the transition to a narrower-spectrum antibiotic without therapeutic failure. Secondary outcomes included the effect on successful de-escalation on patients' hospital length of stay, and the relationship between urine culture results and the success of de-escalation. When determining whether to de-escalate, factors such as clinical stability, and urine culture results and susceptibility were considered. Chi-square test assessed associations between culture results and de-escalation success. RESULTS: A total of 205 patients who received carbapenems as empirical therapy and underwent urine culture testing were included in the study. Out of these, 116 individuals (56.6%) had negative culture results, indicating no infection, while 89 individuals (43.4%) tested positive, confirming the presence of an infection. Among these patients, 95.6% (196 out of 205) required de-escalation of their treatment, whereas 4.4% did not. The prevalence of successful de-escalation was 40.3% (79 out of 196). The…
Read the paper
Related studies
- Association of lower urinary tract symptoms and OAB severity with quality of life and mental health in China, Taiwan and South Korea: results from a cross-sectional, population-based study
- Ten-Day Quadruple Therapy Comprising Low-Dose Rabeprazole, Bismuth, Amoxicillin, and Tetracycline Is an Effective and Safe First-Line Treatment for Helicobacter pylori Infection in a Population with High Antibiotic Resistance: a Prospective, Multicenter, Randomized, Parallel-Controlled Clinical Trial in China
- The Role of the NLR and PLR in Urinary Tract Infection
- Threat of Antimicrobial Resistance among Pilgrims with Infectious Diseases during Hajj: Lessons Learnt from COVID-19 Pandemic
- Leclercia adecarboxylata urinary tract infection in a patient with bladder cancer and recurrent hematuria
- A Case Series of Staphylococcus lugdunensis Infection in Cancer Patients at an Academic Cancer Institute in the United States
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.