{"id":28741,"date":"2025-08-25T04:34:00","date_gmt":"2025-08-24T20:34:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=28741"},"modified":"2025-08-25T05:49:10","modified_gmt":"2025-08-24T21:49:10","slug":"clin-infect-dis%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e9%92%88%e5%af%b9%e9%9d%a9%e5%85%b0%e9%98%b4%e6%80%a7%e8%8f%8c%e7%9a%84%e5%b9%bf%e8%b0%b1%e6%8a%97%e7%94%9f%e7%b4%a0%e5%bb%b6%e8%bf%9f","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=28741","title":{"rendered":"[Clin Infect Dis\u53d1\u8868\u8bba\u6587]\uff1a\u9488\u5bf9\u9769\u5170\u9634\u6027\u83cc\u7684\u5e7f\u8c31\u6297\u751f\u7d20\u5ef6\u8fdf\u6cbb\u7597\u4e0e\u4e34\u5e8a\u9884\u540e\u7684\u76f8\u5173\u6027"},"content":{"rendered":"\n

JOURNAL ARTICLE<\/p>\n\n\n\n

Association Between Delayed Broad-Spectrum Gram-negative Antibiotics and Clinical Outcomes: How Much Does Getting It Right With Empiric Antibiotics Matter?<\/em><\/h1>\n\n\n\n

Jonathan D Baghdadi, Katherine E Goodman, Laurence S Magder, et al<\/h3>\n\n\n\n

Clin Infect Dis 2025; 80: 949-958<\/h3>\n\n\n\n

https:\/\/doi.org\/10.1093\/cid\/ciaf039<\/a><\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

Background<\/p>\n\n\n\n

Clinicians often start unnecessarily broad-spectrum empiric gram-negative antibiotics out of the concern that delaying effective therapy could lead to a worse clinical outcome. This study examined the consequences of delayed initiation of broad-spectrum gram-negative antibiotics.<\/p>\n\n\n\n

Methods<\/p>\n\n\n\n

In a retrospective cohort of adult inpatients from 928 US hospitals, we compared clinical outcomes after (1) empiric narrow-spectrum antibiotics escalated to broad-spectrum antibiotics (delayed broad-spectrum therapy [DBT]) and (2) empiric broad-spectrum antibiotics continued as post-empiric therapy (early broad-spectrum therapy [EBT]) using Win Ratios. DBT and EBT patients were matched on hospital, admitting diagnosis, and propensity scores incorporating 28 clinical variables. The outcome of interest was a ranked composite of mortality, readmission, and adverse drug events.<\/p>\n\n\n\n

Results<\/p>\n\n\n\n

Out of 746 880 inpatients, 82 276 (11%) received DBT and 664 604 (89.0%) received EBT. Among the 67 046 with DBT who were matched to 67 046 with EBT, mortality was 8.7% after DBT and 9.5% after EBT (P<\/em>\u00a0= .022), readmission was 10.5% after DBT and 11.8% after EBT (P<\/em>\u00a0< .0001), and the rate of adverse drug events was 8.4% after DBT and 7.2% after EBT (P<\/em>\u00a0< .0001). Among matched patients, clinical outcomes were superior after DBT compared with EBT (win-ratio 1.06;\u00a0P<\/em>\u00a0< .0001).<\/p>\n\n\n\n

\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n

Conclusions<\/p>\n\n\n\n

On average, among a large sample of adult inpatients who ultimately received broad-spectrum antibiotic therapy, delaying initiation of a broad-spectrum antibiotic was not associated with worse outcomes. Although broad-spectrum empiric therapy is undoubtedly sometimes warranted, this finding challenges the common belief that is it safer to err towards overly broad-spectrum empiric antibiotic therapy.<\/p>\n","protected":false},"excerpt":{"rendered":"

JOURNAL ARTICLE Association Between Delayed Broad-Spect […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28741"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=28741"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28741\/revisions"}],"predecessor-version":[{"id":28933,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28741\/revisions\/28933"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=28741"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=28741"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=28741"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}