Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study
Purpose The DIANA study aimed to evaluate how often antimicrobial de-escalation (ADE) of empirical treatment is performed in the intensive care unit (ICU) and to estimate the effect of ADE on clinical cure on day 7 following treatment initiation. Methods Adult ICU patients receiving empirical antimi...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
De Bus, Liesbet [verfasserIn] Depuydt, Pieter [verfasserIn] Steen, Johan [verfasserIn] Dhaese, Sofie [verfasserIn] De Smet, Ken [verfasserIn] Tabah, Alexis [verfasserIn] Akova, Murat [verfasserIn] Cotta, Menino Osbert [verfasserIn] De Pascale, Gennaro [verfasserIn] Dimopoulos, George [verfasserIn] Fujitani, Shigeki [verfasserIn] Garnacho-Montero, Jose [verfasserIn] Leone, Marc [verfasserIn] Lipman, Jeffrey [verfasserIn] Ostermann, Marlies [verfasserIn] Paiva, José-Artur [verfasserIn] Schouten, Jeroen [verfasserIn] Sjövall, Fredrik [verfasserIn] Timsit, Jean-François [verfasserIn] Roberts, Jason A. [verfasserIn] Zahar, Jean-Ralph [verfasserIn] Zand, Farid [verfasserIn] Zirpe, Kapil [verfasserIn] De Waele, Jan J. [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2020 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
Enthalten in: Intensive care medicine - Berlin : Springer, 1975, 46(2020), 7 vom: 09. Juni, Seite 1404-1417 |
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| Übergeordnetes Werk: |
volume:46 ; year:2020 ; number:7 ; day:09 ; month:06 ; pages:1404-1417 |
| Links: |
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| DOI / URN: |
10.1007/s00134-020-06111-5 |
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| Katalog-ID: |
SPR040243419 |
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| 245 | 1 | 0 | |a Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study |
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| 520 | |a Purpose The DIANA study aimed to evaluate how often antimicrobial de-escalation (ADE) of empirical treatment is performed in the intensive care unit (ICU) and to estimate the effect of ADE on clinical cure on day 7 following treatment initiation. Methods Adult ICU patients receiving empirical antimicrobial therapy for bacterial infection were studied in a prospective observational study from October 2016 until May 2018. ADE was defined as (1) discontinuation of an antimicrobial in case of empirical combination therapy or (2) replacement of an antimicrobial with the intention to narrow the antimicrobial spectrum, within the first 3 days of therapy. Inverse probability (IP) weighting was used to account for time-varying confounding when estimating the effect of ADE on clinical cure. Results Overall, 1495 patients from 152 ICUs in 28 countries were studied. Combination therapy was prescribed in 50%, and carbapenems were prescribed in 26% of patients. Empirical therapy underwent ADE, no change and change other than ADE within the first 3 days in 16%, 63% and 22%, respectively. Unadjusted mortality at day 28 was 15.8% in the ADE cohort and 19.4% in patients with no change [p = 0.27; RR 0.83 (95% CI 0.60–1.14)]. The IP-weighted relative risk estimate for clinical cure comparing ADE with no-ADE patients (no change or change other than ADE) was 1.37 (95% CI 1.14–1.64). Conclusion ADE was infrequently applied in critically ill-infected patients. The observational effect estimate on clinical cure suggested no deleterious impact of ADE compared to no-ADE. However, residual confounding is likely. | ||
| 650 | 4 | |a Antimicrobial de-escalation |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Intensive care unit |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Bacterial infection |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Empirical therapy |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Clinical cure |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Depuydt, Pieter |e verfasserin |4 aut | |
| 700 | 1 | |a Steen, Johan |e verfasserin |4 aut | |
| 700 | 1 | |a Dhaese, Sofie |e verfasserin |4 aut | |
| 700 | 1 | |a De Smet, Ken |e verfasserin |4 aut | |
| 700 | 1 | |a Tabah, Alexis |e verfasserin |4 aut | |
| 700 | 1 | |a Akova, Murat |e verfasserin |4 aut | |
| 700 | 1 | |a Cotta, Menino Osbert |e verfasserin |4 aut | |
| 700 | 1 | |a De Pascale, Gennaro |e verfasserin |4 aut | |
| 700 | 1 | |a Dimopoulos, George |e verfasserin |4 aut | |
| 700 | 1 | |a Fujitani, Shigeki |e verfasserin |4 aut | |
| 700 | 1 | |a Garnacho-Montero, Jose |e verfasserin |4 aut | |
| 700 | 1 | |a Leone, Marc |e verfasserin |4 aut | |
| 700 | 1 | |a Lipman, Jeffrey |e verfasserin |4 aut | |
| 700 | 1 | |a Ostermann, Marlies |e verfasserin |4 aut | |
| 700 | 1 | |a Paiva, José-Artur |e verfasserin |4 aut | |
| 700 | 1 | |a Schouten, Jeroen |e verfasserin |4 aut | |
| 700 | 1 | |a Sjövall, Fredrik |e verfasserin |4 aut | |
| 700 | 1 | |a Timsit, Jean-François |e verfasserin |4 aut | |
| 700 | 1 | |a Roberts, Jason A. |e verfasserin |4 aut | |
| 700 | 1 | |a Zahar, Jean-Ralph |e verfasserin |4 aut | |
| 700 | 1 | |a Zand, Farid |e verfasserin |4 aut | |
| 700 | 1 | |a Zirpe, Kapil |e verfasserin |4 aut | |
| 700 | 1 | |a De Waele, Jan J. |e verfasserin |4 aut | |
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10.1007/s00134-020-06111-5 doi (DE-627)SPR040243419 (SPR)s00134-020-06111-5-e DE-627 ger DE-627 rakwb eng 610 ASE 44.69 bkl De Bus, Liesbet verfasserin aut Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose The DIANA study aimed to evaluate how often antimicrobial de-escalation (ADE) of empirical treatment is performed in the intensive care unit (ICU) and to estimate the effect of ADE on clinical cure on day 7 following treatment initiation. Methods Adult ICU patients receiving empirical antimicrobial therapy for bacterial infection were studied in a prospective observational study from October 2016 until May 2018. ADE was defined as (1) discontinuation of an antimicrobial in case of empirical combination therapy or (2) replacement of an antimicrobial with the intention to narrow the antimicrobial spectrum, within the first 3 days of therapy. Inverse probability (IP) weighting was used to account for time-varying confounding when estimating the effect of ADE on clinical cure. Results Overall, 1495 patients from 152 ICUs in 28 countries were studied. Combination therapy was prescribed in 50%, and carbapenems were prescribed in 26% of patients. Empirical therapy underwent ADE, no change and change other than ADE within the first 3 days in 16%, 63% and 22%, respectively. Unadjusted mortality at day 28 was 15.8% in the ADE cohort and 19.4% in patients with no change [p = 0.27; RR 0.83 (95% CI 0.60–1.14)]. The IP-weighted relative risk estimate for clinical cure comparing ADE with no-ADE patients (no change or change other than ADE) was 1.37 (95% CI 1.14–1.64). Conclusion ADE was infrequently applied in critically ill-infected patients. The observational effect estimate on clinical cure suggested no deleterious impact of ADE compared to no-ADE. However, residual confounding is likely. Antimicrobial de-escalation (dpeaa)DE-He213 Intensive care unit (dpeaa)DE-He213 Bacterial infection (dpeaa)DE-He213 Empirical therapy (dpeaa)DE-He213 Clinical cure (dpeaa)DE-He213 Depuydt, Pieter verfasserin aut Steen, Johan verfasserin aut Dhaese, Sofie verfasserin aut De Smet, Ken verfasserin aut Tabah, Alexis verfasserin aut Akova, Murat verfasserin aut Cotta, Menino Osbert verfasserin aut De Pascale, Gennaro verfasserin aut Dimopoulos, George verfasserin aut Fujitani, Shigeki verfasserin aut Garnacho-Montero, Jose verfasserin aut Leone, Marc verfasserin aut Lipman, Jeffrey verfasserin aut Ostermann, Marlies verfasserin aut Paiva, José-Artur verfasserin aut Schouten, Jeroen verfasserin aut Sjövall, Fredrik verfasserin aut Timsit, Jean-François verfasserin aut Roberts, Jason A. verfasserin aut Zahar, Jean-Ralph verfasserin aut Zand, Farid verfasserin aut Zirpe, Kapil verfasserin aut De Waele, Jan J. verfasserin aut Enthalten in Intensive care medicine Berlin : Springer, 1975 46(2020), 7 vom: 09. Juni, Seite 1404-1417 (DE-627)253724104 (DE-600)1459201-0 1432-1238 nnns volume:46 year:2020 number:7 day:09 month:06 pages:1404-1417 https://dx.doi.org/10.1007/s00134-020-06111-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.69 ASE AR 46 2020 7 09 06 1404-1417 |
| spelling |
10.1007/s00134-020-06111-5 doi (DE-627)SPR040243419 (SPR)s00134-020-06111-5-e DE-627 ger DE-627 rakwb eng 610 ASE 44.69 bkl De Bus, Liesbet verfasserin aut Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose The DIANA study aimed to evaluate how often antimicrobial de-escalation (ADE) of empirical treatment is performed in the intensive care unit (ICU) and to estimate the effect of ADE on clinical cure on day 7 following treatment initiation. Methods Adult ICU patients receiving empirical antimicrobial therapy for bacterial infection were studied in a prospective observational study from October 2016 until May 2018. ADE was defined as (1) discontinuation of an antimicrobial in case of empirical combination therapy or (2) replacement of an antimicrobial with the intention to narrow the antimicrobial spectrum, within the first 3 days of therapy. Inverse probability (IP) weighting was used to account for time-varying confounding when estimating the effect of ADE on clinical cure. Results Overall, 1495 patients from 152 ICUs in 28 countries were studied. Combination therapy was prescribed in 50%, and carbapenems were prescribed in 26% of patients. Empirical therapy underwent ADE, no change and change other than ADE within the first 3 days in 16%, 63% and 22%, respectively. Unadjusted mortality at day 28 was 15.8% in the ADE cohort and 19.4% in patients with no change [p = 0.27; RR 0.83 (95% CI 0.60–1.14)]. The IP-weighted relative risk estimate for clinical cure comparing ADE with no-ADE patients (no change or change other than ADE) was 1.37 (95% CI 1.14–1.64). Conclusion ADE was infrequently applied in critically ill-infected patients. The observational effect estimate on clinical cure suggested no deleterious impact of ADE compared to no-ADE. However, residual confounding is likely. Antimicrobial de-escalation (dpeaa)DE-He213 Intensive care unit (dpeaa)DE-He213 Bacterial infection (dpeaa)DE-He213 Empirical therapy (dpeaa)DE-He213 Clinical cure (dpeaa)DE-He213 Depuydt, Pieter verfasserin aut Steen, Johan verfasserin aut Dhaese, Sofie verfasserin aut De Smet, Ken verfasserin aut Tabah, Alexis verfasserin aut Akova, Murat verfasserin aut Cotta, Menino Osbert verfasserin aut De Pascale, Gennaro verfasserin aut Dimopoulos, George verfasserin aut Fujitani, Shigeki verfasserin aut Garnacho-Montero, Jose verfasserin aut Leone, Marc verfasserin aut Lipman, Jeffrey verfasserin aut Ostermann, Marlies verfasserin aut Paiva, José-Artur verfasserin aut Schouten, Jeroen verfasserin aut Sjövall, Fredrik verfasserin aut Timsit, Jean-François verfasserin aut Roberts, Jason A. verfasserin aut Zahar, Jean-Ralph verfasserin aut Zand, Farid verfasserin aut Zirpe, Kapil verfasserin aut De Waele, Jan J. verfasserin aut Enthalten in Intensive care medicine Berlin : Springer, 1975 46(2020), 7 vom: 09. Juni, Seite 1404-1417 (DE-627)253724104 (DE-600)1459201-0 1432-1238 nnns volume:46 year:2020 number:7 day:09 month:06 pages:1404-1417 https://dx.doi.org/10.1007/s00134-020-06111-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.69 ASE AR 46 2020 7 09 06 1404-1417 |
| allfields_unstemmed |
10.1007/s00134-020-06111-5 doi (DE-627)SPR040243419 (SPR)s00134-020-06111-5-e DE-627 ger DE-627 rakwb eng 610 ASE 44.69 bkl De Bus, Liesbet verfasserin aut Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose The DIANA study aimed to evaluate how often antimicrobial de-escalation (ADE) of empirical treatment is performed in the intensive care unit (ICU) and to estimate the effect of ADE on clinical cure on day 7 following treatment initiation. Methods Adult ICU patients receiving empirical antimicrobial therapy for bacterial infection were studied in a prospective observational study from October 2016 until May 2018. ADE was defined as (1) discontinuation of an antimicrobial in case of empirical combination therapy or (2) replacement of an antimicrobial with the intention to narrow the antimicrobial spectrum, within the first 3 days of therapy. Inverse probability (IP) weighting was used to account for time-varying confounding when estimating the effect of ADE on clinical cure. Results Overall, 1495 patients from 152 ICUs in 28 countries were studied. Combination therapy was prescribed in 50%, and carbapenems were prescribed in 26% of patients. Empirical therapy underwent ADE, no change and change other than ADE within the first 3 days in 16%, 63% and 22%, respectively. Unadjusted mortality at day 28 was 15.8% in the ADE cohort and 19.4% in patients with no change [p = 0.27; RR 0.83 (95% CI 0.60–1.14)]. The IP-weighted relative risk estimate for clinical cure comparing ADE with no-ADE patients (no change or change other than ADE) was 1.37 (95% CI 1.14–1.64). Conclusion ADE was infrequently applied in critically ill-infected patients. The observational effect estimate on clinical cure suggested no deleterious impact of ADE compared to no-ADE. However, residual confounding is likely. Antimicrobial de-escalation (dpeaa)DE-He213 Intensive care unit (dpeaa)DE-He213 Bacterial infection (dpeaa)DE-He213 Empirical therapy (dpeaa)DE-He213 Clinical cure (dpeaa)DE-He213 Depuydt, Pieter verfasserin aut Steen, Johan verfasserin aut Dhaese, Sofie verfasserin aut De Smet, Ken verfasserin aut Tabah, Alexis verfasserin aut Akova, Murat verfasserin aut Cotta, Menino Osbert verfasserin aut De Pascale, Gennaro verfasserin aut Dimopoulos, George verfasserin aut Fujitani, Shigeki verfasserin aut Garnacho-Montero, Jose verfasserin aut Leone, Marc verfasserin aut Lipman, Jeffrey verfasserin aut Ostermann, Marlies verfasserin aut Paiva, José-Artur verfasserin aut Schouten, Jeroen verfasserin aut Sjövall, Fredrik verfasserin aut Timsit, Jean-François verfasserin aut Roberts, Jason A. verfasserin aut Zahar, Jean-Ralph verfasserin aut Zand, Farid verfasserin aut Zirpe, Kapil verfasserin aut De Waele, Jan J. verfasserin aut Enthalten in Intensive care medicine Berlin : Springer, 1975 46(2020), 7 vom: 09. Juni, Seite 1404-1417 (DE-627)253724104 (DE-600)1459201-0 1432-1238 nnns volume:46 year:2020 number:7 day:09 month:06 pages:1404-1417 https://dx.doi.org/10.1007/s00134-020-06111-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.69 ASE AR 46 2020 7 09 06 1404-1417 |
| allfieldsGer |
10.1007/s00134-020-06111-5 doi (DE-627)SPR040243419 (SPR)s00134-020-06111-5-e DE-627 ger DE-627 rakwb eng 610 ASE 44.69 bkl De Bus, Liesbet verfasserin aut Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose The DIANA study aimed to evaluate how often antimicrobial de-escalation (ADE) of empirical treatment is performed in the intensive care unit (ICU) and to estimate the effect of ADE on clinical cure on day 7 following treatment initiation. Methods Adult ICU patients receiving empirical antimicrobial therapy for bacterial infection were studied in a prospective observational study from October 2016 until May 2018. ADE was defined as (1) discontinuation of an antimicrobial in case of empirical combination therapy or (2) replacement of an antimicrobial with the intention to narrow the antimicrobial spectrum, within the first 3 days of therapy. Inverse probability (IP) weighting was used to account for time-varying confounding when estimating the effect of ADE on clinical cure. Results Overall, 1495 patients from 152 ICUs in 28 countries were studied. Combination therapy was prescribed in 50%, and carbapenems were prescribed in 26% of patients. Empirical therapy underwent ADE, no change and change other than ADE within the first 3 days in 16%, 63% and 22%, respectively. Unadjusted mortality at day 28 was 15.8% in the ADE cohort and 19.4% in patients with no change [p = 0.27; RR 0.83 (95% CI 0.60–1.14)]. The IP-weighted relative risk estimate for clinical cure comparing ADE with no-ADE patients (no change or change other than ADE) was 1.37 (95% CI 1.14–1.64). Conclusion ADE was infrequently applied in critically ill-infected patients. The observational effect estimate on clinical cure suggested no deleterious impact of ADE compared to no-ADE. However, residual confounding is likely. Antimicrobial de-escalation (dpeaa)DE-He213 Intensive care unit (dpeaa)DE-He213 Bacterial infection (dpeaa)DE-He213 Empirical therapy (dpeaa)DE-He213 Clinical cure (dpeaa)DE-He213 Depuydt, Pieter verfasserin aut Steen, Johan verfasserin aut Dhaese, Sofie verfasserin aut De Smet, Ken verfasserin aut Tabah, Alexis verfasserin aut Akova, Murat verfasserin aut Cotta, Menino Osbert verfasserin aut De Pascale, Gennaro verfasserin aut Dimopoulos, George verfasserin aut Fujitani, Shigeki verfasserin aut Garnacho-Montero, Jose verfasserin aut Leone, Marc verfasserin aut Lipman, Jeffrey verfasserin aut Ostermann, Marlies verfasserin aut Paiva, José-Artur verfasserin aut Schouten, Jeroen verfasserin aut Sjövall, Fredrik verfasserin aut Timsit, Jean-François verfasserin aut Roberts, Jason A. verfasserin aut Zahar, Jean-Ralph verfasserin aut Zand, Farid verfasserin aut Zirpe, Kapil verfasserin aut De Waele, Jan J. verfasserin aut Enthalten in Intensive care medicine Berlin : Springer, 1975 46(2020), 7 vom: 09. Juni, Seite 1404-1417 (DE-627)253724104 (DE-600)1459201-0 1432-1238 nnns volume:46 year:2020 number:7 day:09 month:06 pages:1404-1417 https://dx.doi.org/10.1007/s00134-020-06111-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.69 ASE AR 46 2020 7 09 06 1404-1417 |
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10.1007/s00134-020-06111-5 doi (DE-627)SPR040243419 (SPR)s00134-020-06111-5-e DE-627 ger DE-627 rakwb eng 610 ASE 44.69 bkl De Bus, Liesbet verfasserin aut Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose The DIANA study aimed to evaluate how often antimicrobial de-escalation (ADE) of empirical treatment is performed in the intensive care unit (ICU) and to estimate the effect of ADE on clinical cure on day 7 following treatment initiation. Methods Adult ICU patients receiving empirical antimicrobial therapy for bacterial infection were studied in a prospective observational study from October 2016 until May 2018. ADE was defined as (1) discontinuation of an antimicrobial in case of empirical combination therapy or (2) replacement of an antimicrobial with the intention to narrow the antimicrobial spectrum, within the first 3 days of therapy. Inverse probability (IP) weighting was used to account for time-varying confounding when estimating the effect of ADE on clinical cure. Results Overall, 1495 patients from 152 ICUs in 28 countries were studied. Combination therapy was prescribed in 50%, and carbapenems were prescribed in 26% of patients. Empirical therapy underwent ADE, no change and change other than ADE within the first 3 days in 16%, 63% and 22%, respectively. Unadjusted mortality at day 28 was 15.8% in the ADE cohort and 19.4% in patients with no change [p = 0.27; RR 0.83 (95% CI 0.60–1.14)]. The IP-weighted relative risk estimate for clinical cure comparing ADE with no-ADE patients (no change or change other than ADE) was 1.37 (95% CI 1.14–1.64). Conclusion ADE was infrequently applied in critically ill-infected patients. The observational effect estimate on clinical cure suggested no deleterious impact of ADE compared to no-ADE. However, residual confounding is likely. Antimicrobial de-escalation (dpeaa)DE-He213 Intensive care unit (dpeaa)DE-He213 Bacterial infection (dpeaa)DE-He213 Empirical therapy (dpeaa)DE-He213 Clinical cure (dpeaa)DE-He213 Depuydt, Pieter verfasserin aut Steen, Johan verfasserin aut Dhaese, Sofie verfasserin aut De Smet, Ken verfasserin aut Tabah, Alexis verfasserin aut Akova, Murat verfasserin aut Cotta, Menino Osbert verfasserin aut De Pascale, Gennaro verfasserin aut Dimopoulos, George verfasserin aut Fujitani, Shigeki verfasserin aut Garnacho-Montero, Jose verfasserin aut Leone, Marc verfasserin aut Lipman, Jeffrey verfasserin aut Ostermann, Marlies verfasserin aut Paiva, José-Artur verfasserin aut Schouten, Jeroen verfasserin aut Sjövall, Fredrik verfasserin aut Timsit, Jean-François verfasserin aut Roberts, Jason A. verfasserin aut Zahar, Jean-Ralph verfasserin aut Zand, Farid verfasserin aut Zirpe, Kapil verfasserin aut De Waele, Jan J. verfasserin aut Enthalten in Intensive care medicine Berlin : Springer, 1975 46(2020), 7 vom: 09. Juni, Seite 1404-1417 (DE-627)253724104 (DE-600)1459201-0 1432-1238 nnns volume:46 year:2020 number:7 day:09 month:06 pages:1404-1417 https://dx.doi.org/10.1007/s00134-020-06111-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.69 ASE AR 46 2020 7 09 06 1404-1417 |
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Enthalten in Intensive care medicine 46(2020), 7 vom: 09. Juni, Seite 1404-1417 volume:46 year:2020 number:7 day:09 month:06 pages:1404-1417 |
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Antimicrobial de-escalation Intensive care unit Bacterial infection Empirical therapy Clinical cure |
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De Bus, Liesbet @@aut@@ Depuydt, Pieter @@aut@@ Steen, Johan @@aut@@ Dhaese, Sofie @@aut@@ De Smet, Ken @@aut@@ Tabah, Alexis @@aut@@ Akova, Murat @@aut@@ Cotta, Menino Osbert @@aut@@ De Pascale, Gennaro @@aut@@ Dimopoulos, George @@aut@@ Fujitani, Shigeki @@aut@@ Garnacho-Montero, Jose @@aut@@ Leone, Marc @@aut@@ Lipman, Jeffrey @@aut@@ Ostermann, Marlies @@aut@@ Paiva, José-Artur @@aut@@ Schouten, Jeroen @@aut@@ Sjövall, Fredrik @@aut@@ Timsit, Jean-François @@aut@@ Roberts, Jason A. @@aut@@ Zahar, Jean-Ralph @@aut@@ Zand, Farid @@aut@@ Zirpe, Kapil @@aut@@ De Waele, Jan J. @@aut@@ |
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2020-06-09T00:00:00Z |
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Methods Adult ICU patients receiving empirical antimicrobial therapy for bacterial infection were studied in a prospective observational study from October 2016 until May 2018. ADE was defined as (1) discontinuation of an antimicrobial in case of empirical combination therapy or (2) replacement of an antimicrobial with the intention to narrow the antimicrobial spectrum, within the first 3 days of therapy. Inverse probability (IP) weighting was used to account for time-varying confounding when estimating the effect of ADE on clinical cure. Results Overall, 1495 patients from 152 ICUs in 28 countries were studied. Combination therapy was prescribed in 50%, and carbapenems were prescribed in 26% of patients. Empirical therapy underwent ADE, no change and change other than ADE within the first 3 days in 16%, 63% and 22%, respectively. Unadjusted mortality at day 28 was 15.8% in the ADE cohort and 19.4% in patients with no change [p = 0.27; RR 0.83 (95% CI 0.60–1.14)]. 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De Bus, Liesbet |
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De Bus, Liesbet ddc 610 bkl 44.69 misc Antimicrobial de-escalation misc Intensive care unit misc Bacterial infection misc Empirical therapy misc Clinical cure Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study |
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610 ASE 44.69 bkl Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study Antimicrobial de-escalation (dpeaa)DE-He213 Intensive care unit (dpeaa)DE-He213 Bacterial infection (dpeaa)DE-He213 Empirical therapy (dpeaa)DE-He213 Clinical cure (dpeaa)DE-He213 |
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De Bus, Liesbet Depuydt, Pieter Steen, Johan Dhaese, Sofie De Smet, Ken Tabah, Alexis Akova, Murat Cotta, Menino Osbert De Pascale, Gennaro Dimopoulos, George Fujitani, Shigeki Garnacho-Montero, Jose Leone, Marc Lipman, Jeffrey Ostermann, Marlies Paiva, José-Artur Schouten, Jeroen Sjövall, Fredrik Timsit, Jean-François Roberts, Jason A. Zahar, Jean-Ralph Zand, Farid Zirpe, Kapil De Waele, Jan J. |
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10.1007/s00134-020-06111-5 |
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antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the diana study |
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Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study |
| abstract |
Purpose The DIANA study aimed to evaluate how often antimicrobial de-escalation (ADE) of empirical treatment is performed in the intensive care unit (ICU) and to estimate the effect of ADE on clinical cure on day 7 following treatment initiation. Methods Adult ICU patients receiving empirical antimicrobial therapy for bacterial infection were studied in a prospective observational study from October 2016 until May 2018. ADE was defined as (1) discontinuation of an antimicrobial in case of empirical combination therapy or (2) replacement of an antimicrobial with the intention to narrow the antimicrobial spectrum, within the first 3 days of therapy. Inverse probability (IP) weighting was used to account for time-varying confounding when estimating the effect of ADE on clinical cure. Results Overall, 1495 patients from 152 ICUs in 28 countries were studied. Combination therapy was prescribed in 50%, and carbapenems were prescribed in 26% of patients. Empirical therapy underwent ADE, no change and change other than ADE within the first 3 days in 16%, 63% and 22%, respectively. Unadjusted mortality at day 28 was 15.8% in the ADE cohort and 19.4% in patients with no change [p = 0.27; RR 0.83 (95% CI 0.60–1.14)]. The IP-weighted relative risk estimate for clinical cure comparing ADE with no-ADE patients (no change or change other than ADE) was 1.37 (95% CI 1.14–1.64). Conclusion ADE was infrequently applied in critically ill-infected patients. The observational effect estimate on clinical cure suggested no deleterious impact of ADE compared to no-ADE. However, residual confounding is likely. |
| abstractGer |
Purpose The DIANA study aimed to evaluate how often antimicrobial de-escalation (ADE) of empirical treatment is performed in the intensive care unit (ICU) and to estimate the effect of ADE on clinical cure on day 7 following treatment initiation. Methods Adult ICU patients receiving empirical antimicrobial therapy for bacterial infection were studied in a prospective observational study from October 2016 until May 2018. ADE was defined as (1) discontinuation of an antimicrobial in case of empirical combination therapy or (2) replacement of an antimicrobial with the intention to narrow the antimicrobial spectrum, within the first 3 days of therapy. Inverse probability (IP) weighting was used to account for time-varying confounding when estimating the effect of ADE on clinical cure. Results Overall, 1495 patients from 152 ICUs in 28 countries were studied. Combination therapy was prescribed in 50%, and carbapenems were prescribed in 26% of patients. Empirical therapy underwent ADE, no change and change other than ADE within the first 3 days in 16%, 63% and 22%, respectively. Unadjusted mortality at day 28 was 15.8% in the ADE cohort and 19.4% in patients with no change [p = 0.27; RR 0.83 (95% CI 0.60–1.14)]. The IP-weighted relative risk estimate for clinical cure comparing ADE with no-ADE patients (no change or change other than ADE) was 1.37 (95% CI 1.14–1.64). Conclusion ADE was infrequently applied in critically ill-infected patients. The observational effect estimate on clinical cure suggested no deleterious impact of ADE compared to no-ADE. However, residual confounding is likely. |
| abstract_unstemmed |
Purpose The DIANA study aimed to evaluate how often antimicrobial de-escalation (ADE) of empirical treatment is performed in the intensive care unit (ICU) and to estimate the effect of ADE on clinical cure on day 7 following treatment initiation. Methods Adult ICU patients receiving empirical antimicrobial therapy for bacterial infection were studied in a prospective observational study from October 2016 until May 2018. ADE was defined as (1) discontinuation of an antimicrobial in case of empirical combination therapy or (2) replacement of an antimicrobial with the intention to narrow the antimicrobial spectrum, within the first 3 days of therapy. Inverse probability (IP) weighting was used to account for time-varying confounding when estimating the effect of ADE on clinical cure. Results Overall, 1495 patients from 152 ICUs in 28 countries were studied. Combination therapy was prescribed in 50%, and carbapenems were prescribed in 26% of patients. Empirical therapy underwent ADE, no change and change other than ADE within the first 3 days in 16%, 63% and 22%, respectively. Unadjusted mortality at day 28 was 15.8% in the ADE cohort and 19.4% in patients with no change [p = 0.27; RR 0.83 (95% CI 0.60–1.14)]. The IP-weighted relative risk estimate for clinical cure comparing ADE with no-ADE patients (no change or change other than ADE) was 1.37 (95% CI 1.14–1.64). Conclusion ADE was infrequently applied in critically ill-infected patients. The observational effect estimate on clinical cure suggested no deleterious impact of ADE compared to no-ADE. However, residual confounding is likely. |
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Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study |
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https://dx.doi.org/10.1007/s00134-020-06111-5 |
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Depuydt, Pieter Steen, Johan Dhaese, Sofie De Smet, Ken Tabah, Alexis Akova, Murat Cotta, Menino Osbert De Pascale, Gennaro Dimopoulos, George Fujitani, Shigeki Garnacho-Montero, Jose Leone, Marc Lipman, Jeffrey Ostermann, Marlies Paiva, José-Artur Schouten, Jeroen Sjövall, Fredrik Timsit, Jean-François Roberts, Jason A. Zahar, Jean-Ralph Zand, Farid Zirpe, Kapil De Waele, Jan J. |
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Depuydt, Pieter Steen, Johan Dhaese, Sofie De Smet, Ken Tabah, Alexis Akova, Murat Cotta, Menino Osbert De Pascale, Gennaro Dimopoulos, George Fujitani, Shigeki Garnacho-Montero, Jose Leone, Marc Lipman, Jeffrey Ostermann, Marlies Paiva, José-Artur Schouten, Jeroen Sjövall, Fredrik Timsit, Jean-François Roberts, Jason A. Zahar, Jean-Ralph Zand, Farid Zirpe, Kapil De Waele, Jan J. |
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10.1007/s00134-020-06111-5 |
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2024-07-03T14:43:10.739Z |
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| score |
7.399866 |