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X Demographics
Mendeley readers
Attention Score in Context
| Title |
Enhanced antimicrobial de-escalation for pneumonia in mechanically ventilated patients: a cross-over study
|
|---|---|
| Published in |
Critical Care, July 2017
|
| DOI | 10.1186/s13054-017-1772-4 |
| Pubmed ID | |
| Authors |
Tracy Trupka, Kristen Fisher, Scott T. Micek, Paul Juang, Marin H. Kollef |
| Abstract |
Antibiotics are commonly administered to hospitalized patients with infiltrates for possible bacterial pneumonia, often leading to unnecessary treatment and increasing the risk for resistance emergence. Therefore, we performed a study to determine if an enhanced antibiotic de-escalation practice could improve antibiotic utilization in mechanically ventilated patients with suspected pneumonia cared for in an academic closed intensive care unit (ICU). This was a prospective cross-over trial comparing routine antibiotic management (RAM) and enhanced antimicrobial de-escalation (EAD) performed within two medical ICUs (total 34 beds) at Barnes-Jewish Hospital, an academic referral center. Patients in the EAD group had their antibiotic orders and microbiology results reviewed daily by a dedicated team comprised of a second-year critical care fellow, an ICU attending physician and an ICU pharmacist. Antibiotic de-escalation recommendations were made when appropriate based on microbiologic test results and clinical response to therapy. There were 283 patients evaluable, with suspected pneumonia requiring mechanical ventilation: 139 (49.1%) patients in the RAM group and 144 (50.9%) in the EAD group. Early treatment failure based on clinical deterioration occurred in 33 (23.7%) and 40 (27.8%) patients, respectively (P = 0.438). In the remaining patients, antimicrobial de-escalation occurred in 70 (66.0%) and 70 (67.3%), respectively (P = 0.845). There was no difference between groups in total antibiotic days ((median (interquartile range)) 7.0 days (4.0, 9.0) versus 7.0 days (4.0, 8.8) (P = 0.616)); hospital mortality (25.2% versus 35.4% (P = 0.061)); or hospital duration (12.0 days (6.0, 20.0) versus 11.0 days (6.0, 22.0) (P = 0.918). The addition of an EAD program to a high-intensity daytime staffing model already practicing a high-level of antibiotic stewardship in an academic ICU was not associated with greater antibiotic de-escalation or a reduction in the overall duration of antibiotic therapy. ClinicalTrials.gov, NCT02685930 . Registered on 26 January 2016. |
X Demographics
The data shown below were collected from the profiles of 71 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 9 | 13% |
| Colombia | 7 | 10% |
| Mexico | 6 | 8% |
| Spain | 3 | 4% |
| Chile | 3 | 4% |
| United States | 3 | 4% |
| Italy | 2 | 3% |
| Greece | 2 | 3% |
| Brazil | 2 | 3% |
| Other | 13 | 18% |
| Unknown | 21 | 30% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 52 | 73% |
| Practitioners (doctors, other healthcare professionals) | 9 | 13% |
| Scientists | 8 | 11% |
| Science communicators (journalists, bloggers, editors) | 2 | 3% |
Mendeley readers
The data shown below were compiled from readership statistics for 85 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 85 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 9 | 11% |
| Student > Ph. D. Student | 7 | 8% |
| Researcher | 7 | 8% |
| Student > Postgraduate | 7 | 8% |
| Student > Doctoral Student | 6 | 7% |
| Other | 19 | 22% |
| Unknown | 30 | 35% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 35 | 41% |
| Nursing and Health Professions | 5 | 6% |
| Biochemistry, Genetics and Molecular Biology | 4 | 5% |
| Pharmacology, Toxicology and Pharmaceutical Science | 3 | 4% |
| Agricultural and Biological Sciences | 2 | 2% |
| Other | 5 | 6% |
| Unknown | 31 | 36% |
Attention Score in Context
This research output has an Altmetric Attention Score of 44. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 13 September 2019.
All research outputs
#944,807
of 25,382,440 outputs
Outputs from Critical Care
#725
of 6,555 outputs
Outputs of similar age
#19,176
of 324,080 outputs
Outputs of similar age from Critical Care
#18
of 101 outputs
Altmetric has tracked 25,382,440 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 96th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 6,555 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 20.8. This one has done well, scoring higher than 88% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 324,080 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 94% of its contemporaries.
We're also able to compare this research output to 101 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 82% of its contemporaries.