De-escalation of antibiotic therapy
In cases of negative blood cultures in patients receiving antibiotics
with Gram-positive coverage and/or a second antibiotic with
Gram-negative coverage, de-escalation and/or discontinuation of
antibiotics on day 6 in all units significantly increased from 43% to
53.5% (p =0.032). More specifically, it increased from 53.1% to
60.2% in units located in pediatric hospitals and from just 15.1% to
28.3% in units located in general hospitals.
Antibiotic initiation without a clear infectious source or fever and
with ANC>500/μl occurred during the pre-and
post-intervention period in 4.1% and 3% of antibiotic courses,
respectively (p =0.198). In PHO units located in pediatric
hospitals, it tended to drop from 3.7% to 3% and in PHO units located
in general hospitals from 5% to 3%.