Optimizing the Management of Uncomplicated Gram-Negative Bloodstream Infections: Consensus Guidance Using a Modified Delphi Process

Autor:	Jason M. Pogue, Pranita D. Tamma, Sara E. Cosgrove, Tamar F. Barlam, Jacqueline T. Bork, James S. Lewis, Lilian M. Abbo, Liza Vaezi, David R Ha, Michael P. Stevens, Keith S Kaye, Jessica K. Ortwine, Timothy C. Jenkins, Emily S Spivak, Angelina Davis, Emily L. Heil
Rok vydání:	2021
Předmět:	medicine.medical_specialty Closed-ended question medicine.diagnostic_test Response to therapy business.industry Delphi method Modified delphi medicine.disease Infectious Diseases AcademicSubjects/MED00290 Oncology blood cultures Bloodstream infection Antibiotic therapy Bacteremia oral step-down therapy Major Article duration of therapy Medicine Blood culture bacteremia business Intensive care medicine
Zdroj:	Open Forum Infectious Diseases
ISSN:	2328-8957
Popis:	Background Guidance on the recommended durations of antibiotic therapy, the use of oral antibiotic therapy, and the need for repeat blood cultures remain incomplete for gram-negative bloodstream infections. We convened a panel of infectious diseases specialists to develop a consensus definition of uncomplicated gram-negative bloodstream infections to assist clinicians with management decisions. Methods Panelists, who were all blinded to the identity of other members of the panel, used a modified Delphi technique to develop a list of statements describing preferred management approaches for uncomplicated gram-negative bloodstream infections. Panelists provided level of agreement and feedback on consensus statements generated and refined them from the first round of open-ended questions through 3 subsequent rounds. Results Thirteen infectious diseases specialists (7 physicians and 6 pharmacists) from across the United States participated in the consensus process. A definition of uncomplicated gram-negative bloodstream infection was developed. Considerations cited by panelists in determining if a bloodstream infection was uncomplicated included host immune status, response to therapy, organism identified, source of the bacteremia, and source control measures. For patients meeting this definition, panelists largely agreed that a duration of therapy of ~7 days, transitioning to oral antibiotic therapy, and forgoing repeat blood cultures, was reasonable. Conclusions In the absence of professional guidelines for the management of uncomplicated gram-negative bloodstream infections, the consensus statements developed by a panel of infectious diseases specialists can provide guidance to practitioners for a common clinical scenario.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8070251653b16422a7e09ee9fdc5fbaa https://pubmed.ncbi.nlm.nih.gov/34738022 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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