The 2021 Dutch Working Party on Antibiotic Policy (SWAB) guidelines for empirical antibacterial therapy of sepsis in adults
Abstract Background The Dutch Working Party on Antibiotic Policy (SWAB) in collaboration with relevant professional societies, has updated their evidence-based guidelines on empiric antibacterial therapy of sepsis in adults. Methods Our multidisciplinary guideline committee generated ten population,...
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| Format: | Article |
| Language: | English |
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BMC
2022-08-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-022-07653-3 |
| _version_ | 1828154281291677696 |
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| author | Elske Sieswerda Hannelore I. Bax Jacobien J. Hoogerwerf Mark G. J. de Boer Marja Boermeester Marc J. M. Bonten Douwe Dekker Roy Gerth van Wijk Nicole P. Juffermans Marnix Kuindersma Paul D. van der Linden Damian C. Melles Peter Pickkers Jeroen A. Schouten Jasper R. Rebel Arthur R. H. van Zanten Jan M. Prins W. Joost Wiersinga |
| author_facet | Elske Sieswerda Hannelore I. Bax Jacobien J. Hoogerwerf Mark G. J. de Boer Marja Boermeester Marc J. M. Bonten Douwe Dekker Roy Gerth van Wijk Nicole P. Juffermans Marnix Kuindersma Paul D. van der Linden Damian C. Melles Peter Pickkers Jeroen A. Schouten Jasper R. Rebel Arthur R. H. van Zanten Jan M. Prins W. Joost Wiersinga |
| author_sort | Elske Sieswerda |
| collection | DOAJ |
| description | Abstract Background The Dutch Working Party on Antibiotic Policy (SWAB) in collaboration with relevant professional societies, has updated their evidence-based guidelines on empiric antibacterial therapy of sepsis in adults. Methods Our multidisciplinary guideline committee generated ten population, intervention, comparison, and outcome (PICO) questions relevant for adult patients with sepsis. For each question, a literature search was performed to obtain the best available evidence and assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. The quality of evidence for clinically relevant outcomes was graded from high to very low. In structured consensus meetings, the committee formulated recommendations as strong or weak. When evidence could not be obtained, recommendations were provided based on expert opinion and experience (good practice statements). Results Fifty-five recommendations on the antibacterial therapy of sepsis were generated. Recommendations on empiric antibacterial therapy choices were differentiated for sepsis according to the source of infection, the potential causative pathogen and its resistance pattern. One important revision was the distinction between low, increased and high risk of infection with Enterobacterales resistant to third generation cephalosporins (3GRC-E) to guide the choice of empirical therapy. Other new topics included empirical antibacterial therapy in patients with a reported penicillin allergy and the role of pharmacokinetics and pharmacodynamics to guide dosing in sepsis. We also established recommendations on timing and duration of antibacterial treatment. Conclusions Our multidisciplinary committee formulated evidence-based recommendations for the empiric antibacterial therapy of adults with sepsis in The Netherlands. |
| first_indexed | 2024-04-11T22:36:32Z |
| format | Article |
| id | doaj.art-428bc82ef7f045c2b74f25abb5e6bb8a |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-04-11T22:36:32Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-428bc82ef7f045c2b74f25abb5e6bb8a2022-12-22T03:59:11ZengBMCBMC Infectious Diseases1471-23342022-08-0122111610.1186/s12879-022-07653-3The 2021 Dutch Working Party on Antibiotic Policy (SWAB) guidelines for empirical antibacterial therapy of sepsis in adultsElske Sieswerda0Hannelore I. Bax1Jacobien J. Hoogerwerf2Mark G. J. de Boer3Marja Boermeester4Marc J. M. Bonten5Douwe Dekker6Roy Gerth van Wijk7Nicole P. Juffermans8Marnix Kuindersma9Paul D. van der Linden10Damian C. Melles11Peter Pickkers12Jeroen A. Schouten13Jasper R. Rebel14Arthur R. H. van Zanten15Jan M. Prins16W. Joost Wiersinga17Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht UniversityDepartment of Internal Medicine, Section of Infectious Diseases and Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical CenterDepartment of Medicine, Radboud Center for Infectious Diseases, Radboud University Medical CenterDepartment of Infectious Diseases, Leiden University Medical CenterDepartment of Surgery, Amsterdam UMC, University of AmsterdamJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityDepartment of Internal Medicine, University Medical Centre UtrechtDivision of Allergology, Department of Internal Medicine, Erasmus Medical CenterDepartment of Intensive Care, OLVG HospitalDepartment of Intensive Care, Gelre ziekenhuis ApeldoornDepartment of Clinical Pharmacy, Tergooi HospitalDepartment of Medical Microbiology and Immunology, Meander Medical CenterDepartment of Intensive Care Medicine, Radboud Center for Infectious Diseases, Radboud University Medical CenterDepartment of Intensive Care Medicine, Radboud Center for Infectious Diseases, Radboud University Medical CenterDepartment of Emergency Medicine, OLVG HospitalDepartment of Intensive Care Medicine, Ziekenhuis Gelderse ValleiDivision of Infectious Diseases, Department of Medicine, Amsterdam UMC, University of AmsterdamDivision of Infectious Diseases, Department of Medicine, Amsterdam UMC, University of AmsterdamAbstract Background The Dutch Working Party on Antibiotic Policy (SWAB) in collaboration with relevant professional societies, has updated their evidence-based guidelines on empiric antibacterial therapy of sepsis in adults. Methods Our multidisciplinary guideline committee generated ten population, intervention, comparison, and outcome (PICO) questions relevant for adult patients with sepsis. For each question, a literature search was performed to obtain the best available evidence and assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. The quality of evidence for clinically relevant outcomes was graded from high to very low. In structured consensus meetings, the committee formulated recommendations as strong or weak. When evidence could not be obtained, recommendations were provided based on expert opinion and experience (good practice statements). Results Fifty-five recommendations on the antibacterial therapy of sepsis were generated. Recommendations on empiric antibacterial therapy choices were differentiated for sepsis according to the source of infection, the potential causative pathogen and its resistance pattern. One important revision was the distinction between low, increased and high risk of infection with Enterobacterales resistant to third generation cephalosporins (3GRC-E) to guide the choice of empirical therapy. Other new topics included empirical antibacterial therapy in patients with a reported penicillin allergy and the role of pharmacokinetics and pharmacodynamics to guide dosing in sepsis. We also established recommendations on timing and duration of antibacterial treatment. Conclusions Our multidisciplinary committee formulated evidence-based recommendations for the empiric antibacterial therapy of adults with sepsis in The Netherlands.https://doi.org/10.1186/s12879-022-07653-3Antibacterial therapyDuration of antibiotic therapySepsisGuidelinesEmpirical therapyPharmacokinetics |
| spellingShingle | Elske Sieswerda Hannelore I. Bax Jacobien J. Hoogerwerf Mark G. J. de Boer Marja Boermeester Marc J. M. Bonten Douwe Dekker Roy Gerth van Wijk Nicole P. Juffermans Marnix Kuindersma Paul D. van der Linden Damian C. Melles Peter Pickkers Jeroen A. Schouten Jasper R. Rebel Arthur R. H. van Zanten Jan M. Prins W. Joost Wiersinga The 2021 Dutch Working Party on Antibiotic Policy (SWAB) guidelines for empirical antibacterial therapy of sepsis in adults BMC Infectious Diseases Antibacterial therapy Duration of antibiotic therapy Sepsis Guidelines Empirical therapy Pharmacokinetics |
| title | The 2021 Dutch Working Party on Antibiotic Policy (SWAB) guidelines for empirical antibacterial therapy of sepsis in adults |
| title_full | The 2021 Dutch Working Party on Antibiotic Policy (SWAB) guidelines for empirical antibacterial therapy of sepsis in adults |
| title_fullStr | The 2021 Dutch Working Party on Antibiotic Policy (SWAB) guidelines for empirical antibacterial therapy of sepsis in adults |
| title_full_unstemmed | The 2021 Dutch Working Party on Antibiotic Policy (SWAB) guidelines for empirical antibacterial therapy of sepsis in adults |
| title_short | The 2021 Dutch Working Party on Antibiotic Policy (SWAB) guidelines for empirical antibacterial therapy of sepsis in adults |
| title_sort | 2021 dutch working party on antibiotic policy swab guidelines for empirical antibacterial therapy of sepsis in adults |
| topic | Antibacterial therapy Duration of antibiotic therapy Sepsis Guidelines Empirical therapy Pharmacokinetics |
| url | https://doi.org/10.1186/s12879-022-07653-3 |
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