Journal
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS
Volume 60, Issue 2, Pages -Publisher
ELSEVIER
DOI: 10.1016/j.ijantimicag.2022.106611
Keywords
Multidrug resistance; Treatment; Antimicrobial stewardship
Funding
- Italian Society of Infection and Tropical Diseases (SIMIT)
- Italian Society of Anti-Infective Therapy (SITA)
- Italian Group for Antimicrobial Stewardship (GISA)
- Italian Association of Clinical Microbiologists (AMCLI)
- Italian Society of Microbiology (SIM)
Ask authors/readers for more resources
The management of infections caused by multidrug-resistant organisms is challenging and requires a multidisciplinary approach. This paper provides recommendations for the diagnosis and optimal management of these infections, with a focus on targeted antibiotic therapy. However, the available evidence is limited, and some recommendations are based on low certainty. These recommendations should be regularly updated.
Management of patients with infections caused by multidrug-resistant organisms is challenging and requires a multidisciplinary approach to achieve successful clinical outcomes. The aim of this paper is to provide recommendations for the diagnosis and optimal management of these infections, with a focus on targeted antibiotic therapy. The document was produced by a panel of experts nominated by the five endorsing Italian societies, namely the Italian Association of Clinical Microbiologists (AMCLI), the Italian Group for Antimicrobial Stewardship (GISA), the Italian Society of Microbiology (SIM), the Italian Society of Infectious and Tropical Diseases (SIMIT) and the Italian Society of Anti-Infective Therapy (SITA). Population, Intervention, Comparison and Outcomes (PICO) questions about microbiological diagnosis, pharmacological strategies and targeted antibiotic therapy were addressed for the following pathogens: carbapenem-resistant Enterobacterales; carbapenem-resistant Pseudomonas aeruginosa; carbapenem-resistant Acinetobacter baumannii; and methicillin-resistant Staphylococcus aureus. A systematic review of the literature published from January 2011 to November 2020 was guided by the PICO strategy. As data from randomised controlled trials (RCTs) were expected to be limited, observational studies were also reviewed. The certainty of evidence was classified using the GRADE approach. Recommendations were classified as strong or conditional. Detailed recommendations were formulated for each pathogen. The majority of available RCTs have serious risk of bias, and many observational studies have several limitations, including small sample size, retrospective design and presence of confounders. Thus, some recommendations are based on low or very-low certainty of evidence. Importantly, these recommendations should be continually updated to reflect emerging evidence from clinical studies and real-world experience. (C) 2022 The Authors. Published by Elsevier Ltd.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available