ArticleInfection control and hospital epidemiology2021
A "resistance calculator": Simple stewardship intervention for refining empiric practices of antimicrobials in acute-care hospitals.
Article in Infection control and hospital epidemiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05304221 (Prospective Validation of the "Shamir Resistance Calculator"), which is not on this map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prospective Validation of the "Shamir Resistance Calculator": an Interventional Crossover Trial to Improve Empiric Prescription of Antimicrobials in Acute Care Hospitals.
Who cites it
1 citing paper in PubMed.
- Risk Factors of Infections Due to Multidrug-Resistant Gram-Negative Bacteria in a Community Hospital in Rural Thailand.Tropical medicine and infectious disease · 2022Article
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Authors and funding
24 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveIn the era of widespread resistance, there are 2 time points at which most empiric prescription errors occur among hospitalized adults: (1) upon admission (UA) when treating patients at risk of multidrug-resistant organisms (MDROs) and (2) during hospitalization, when treating patients at risk of extensively drug-resistant organisms (XDROs). These errors adversely influence patient outcomes and the hospital's ecology. DESIGN AND
settingRetrospective cohort study, Shamir Medical Center, Israel, 2016. PATIENTS: Adult patients (aged >18 years) hospitalized with sepsis.
methodsLogistic regressions were used to develop predictive models for (1) MDRO UA and (2) nosocomial XDRO. Their performances on the derivation data sets, and on 7 other validation data sets, were assessed using the area under the receiver operating characteristic curve (ROC AUC).
resultsIn total, 4,114 patients were included: 2,472 patients with sepsis UA and 1,642 with nosocomial sepsis. The MDRO UA score included 10 parameters, and with a cutoff of ≥22 points, it had an ROC AUC of 0.85. The nosocomial XDRO score included 7 parameters, and with a cutoff of ≥36 points, it had an ROC AUC of 0.87. The range of ROC AUCs for the validation data sets was 0.7-0.88 for the MDRO UA score and was 0.66-0.75 for nosocomial XDRO score. We created a free web calculator (https://assafharofe.azurewebsites.net).
conclusionsA simple electronic calculator could aid with empiric prescription during an encounter with a septic patient. Future implementation studies are needed to evaluate its utility in improving patient outcomes and in reducing overall resistances.
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