Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Home
Hostname: page-component-768dbb666b-l8xdn Total loading time: 0.548 Render date: 2023-02-08T02:02:40.986Z Has data issue: true Feature Flags: { "useRatesEcommerce": false } hasContentIssue true
  • English
Infection Control & Hospital Epidemiology Infection Control & Hospital Epidemiology

Article contents

Spectrum scores: Toward a better definition of de-escalation

Published online by Cambridge University Press:  09 September 2022

Daniel T. Ilges Open the ORCID record for Daniel T. Ilges[Opens in a new window] ,
David J. Ritchie ,
Tamara Krekel ,
Elizabeth A. Neuner Open the ORCID record for Elizabeth A. Neuner[Opens in a new window]  and
Scott T. Micek
Daniel T. Ilges*
Affiliation:
Mayo Clinic Hospital, Phoenix, Arizona
David J. Ritchie
Affiliation:
Department of Pharmacy, Barnes-Jewish Hospital, St Louis, Missouri
Tamara Krekel
Affiliation:
Department of Pharmacy, Barnes-Jewish Hospital, St Louis, Missouri
Elizabeth A. Neuner
Affiliation:
Department of Pharmacy, Barnes-Jewish Hospital, St Louis, Missouri
Scott T. Micek
Affiliation:
Department of Pharmacy, Barnes-Jewish Hospital, St Louis, Missouri Department of Pharmacy Practice, University of Health Sciences and Pharmacy, St Louis, Missouri
*
Author for correspondence: Daniel T. Ilges, E-mail: ilges.daniel@mayo.edu
Get access Rights & Permissions[Opens in a new window]

Abstract

Spectrum scores measure antimicrobial utilization while also quantifying the spectrum of activity. Accordingly, changes in spectrum score can be used to identify antimicrobial de-escalation. We show that spectrum-score–based de-escalation has a 95.7% positive percentage agreement and 81.6% negative percentage agreement versus de-escalation defined as stopping either antistaphylococcal or antipseudomonal agents.

Type
Concise Communication
Information
Infection Control & Hospital Epidemiology , First View , pp. 1 - 3
Check for updates
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Dellit, TH, Owens, RC, McGowan, JE Jr, et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis 2007;44:159–177.CrossRefGoogle Scholar
Masterton, RG. Antibiotic de-escalation. Crit Care Clin 2011;27:149–162.CrossRefGoogle ScholarPubMed
Weiss, E, Zahar, JR, Lesprit, P, et al. Elaboration of a consensual definition of de-escalation allowing a ranking of beta-lactams. Clin Microbiol Infect 2015;21:649 e1–e10.Google Scholar
Moehring, RW, Ashley, ESD, Davis, AE, et al. Development of an electronic definition for de-escalation of antibiotics in hospitalized patients. Clin Infect Dis 2021;73:e4507–e4514.CrossRefGoogle ScholarPubMed
Cowley, MC, Ritchie, DJ, Hampton, N, Kollef, MH, Micek, ST. Outcomes associated with de-escalating therapy for methicillin-resistant Staphylococcus aureus in culture-negative nosocomial pneumonia. Chest 2019;155:53–59.CrossRefGoogle ScholarPubMed
Kollef, MH, Morrow, LE, Niederman, MS, et al. Clinical characteristics and treatment patterns among patients with ventilator-associated pneumonia. Chest 2006;129:1210–1218.CrossRefGoogle ScholarPubMed
Gerber, JS, Hersh, AL, Kronman, MP, Newland, JG, Ross, RK, Metjian, TA. Development and application of an antibiotic spectrum index for benchmarking antibiotic selection patterns across hospitals. Infect Control Hosp Epidemiol 2017;38:993–997.CrossRefGoogle ScholarPubMed
Ilges, D, Ritchie, DJ, Krekel, T, et al. Assessment of antibiotic de-escalation by spectrum score in patients with nosocomial pneumonia: a single-center, retrospective cohort study. Open Forum Infect Dis 2021;8:ofab508.CrossRefGoogle ScholarPubMed
Brown, KA, Langford, B, Schwartz, KL, Diong, C, Garber, G, Daneman, N. Antibiotic prescribing choices and their comparative C. difficile infection risks: a longitudinal case–cohort study. Clin Infect Dis 2021;72:836–844.CrossRefGoogle ScholarPubMed
Yarrington, ME, Wrenn, RH, Spivey, J, Sarubbi, C, Anderson, DJ, Moehring, RW. Measuring empiric antibiotic spectrum—a journey through space and time. Infect Control Hosp Epidemiol 2022. doi: 10.1017/ice.2022.151.CrossRefGoogle Scholar
Supplementary material: File

Ilges et al. supplementary material

Ilges et al. supplementary material

Download Ilges et al. supplementary material(File)
File 90 KB

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Spectrum scores: Toward a better definition of de-escalation
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Spectrum scores: Toward a better definition of de-escalation
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Spectrum scores: Toward a better definition of de-escalation
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *