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dc.creatorPaul, Micales
dc.creatorCarrara, Elenaes
dc.creatorRetamar Gentil, Pilares
dc.creatorTängdén, Thomases
dc.creatorBitterman, Ronies
dc.creatorBonomo, Robert A.es
dc.creatorRodríguez-Baño, Jesúses
dc.date.accessioned2022-12-14T15:15:28Z
dc.date.available2022-12-14T15:15:28Z
dc.date.issued2022
dc.identifier.citationPaul, M., Carrara, E., Retamar Gentil, P., Tängdén, T., Bitterman, R., Bonomo, R.A. y Rodríguez-Baño, J. (2022). European Society of Clinical Microbiology and Infectious Diseases (ESCMID) guidelines for the treatment of infections caused by multidrug-resistant Gram-negative bacilli (endorsed by European society of intensive care medicine). Clinical Microbiology and Infection, 28 (4), 521-547. https://doi.org/10.1016/j.cmi.2021.11.025.
dc.identifier.issn1198-743Xes
dc.identifier.issn1469-0691es
dc.identifier.urihttps://hdl.handle.net/11441/140459
dc.description.abstractScope: These ESCMID guidelines address the targeted antibiotic treatment of third-generation cepha losporin-resistant Enterobacterales (3GCephRE) and carbapenem-resistant Gram-negative bacteria, focusing on the effectiveness of individual antibiotics and on combination versus monotherapy. Methods: An expert panel was convened by ESCMID. A systematic review was performed including randomized controlled trials and observational studies, examining different antibiotic treatment regi mens for the targeted treatment of infections caused by the 3GCephRE, carbapenem-resistant Enter obacterales, carbapenem-resistant Pseudomonas aeruginosa and carbapenem-resistant Acinetobacter baumannii. Treatments were classified as head-to-head comparisons between individual antibiotics and between monotherapy and combination therapy regimens, including defined monotherapy and com bination regimens only. The primary outcome was all-cause mortality, preferably at 30 days and sec ondary outcomes included clinical failure, microbiological failure, development of resistance, relapse/ recurrence, adverse events and length of hospital stay. The last search of all databases was conducted in December 2019, followed by a focused search for relevant studies up until ECCMID 2021. Data were summarized narratively. The certainty of the evidence for each comparison between antibiotics and between monotherapy and combination therapy regimens was classified by the GRADE recommenda tions. The strength of the recommendations for or against treatments was classified as strong or con ditional (weak). Recommendations: The guideline panel reviewed the evidence per pathogen, preferably per site of infection, critically appraising the existing studies. Many of the comparisons were addressed in small observational studies at high risk of bias only. Notably, there was very little evidence on the effects of the new, recently approved, b-lactam/b-lactamase inhibitors on infections caused by carbapenem-resistant Gram-negative bacteria. Most recommendations are based on very-low- and low-certainty evidence. A high value was placed on antibiotic stewardship considerations in all recommendations, searching for carbapenem-sparing options for 3GCephRE and limiting the recommendations of the new antibiotics for severe infections, as defined by the sepsis-3 criteria.es
dc.formatapplication/pdfes
dc.format.extent27 p.es
dc.language.isoenges
dc.publisherWiley-Blackwelles
dc.relation.ispartofClinical Microbiology and Infection, 28 (4), 521-547.
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internacional*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectAcinetobacter baumanniies
dc.subjectCarbapenem-resistant bacteriaes
dc.subjectMultidrug resistant bacteriaes
dc.subjectESCMIDes
dc.subjectGRADEes
dc.titleEuropean Society of Clinical Microbiology and Infectious Diseases (ESCMID) guidelines for the treatment of infections caused by multidrug-resistant Gram-negative bacilli (endorsed by European society of intensive care medicine)es
dc.typeinfo:eu-repo/semantics/articlees
dcterms.identifierhttps://ror.org/03yxnpp24
dc.type.versioninfo:eu-repo/semantics/publishedVersiones
dc.rights.accessRightsinfo:eu-repo/semantics/openAccesses
dc.contributor.affiliationMedicinaes
dc.relation.publisherversionhttps://www.sciencedirect.com/science/article/pii/S1198743X21006790?via%3Dihubes
dc.identifier.doi10.1016/j.cmi.2021.11.025es
dc.journaltitleClinical Microbiology and Infectiones
dc.publication.volumen28es
dc.publication.issue4es
dc.publication.initialPage521es
dc.publication.endPage547es

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