eHealth and mHealth in Antimicrobial Stewardship to Reduce Mortality in Empirical Antimicrobial Therapy and a Systematic Review with a Meta-Analysis of Adequate Therapy

被引:1
|
作者
Tuon, Felipe Francisco [1 ]
Zequinao, Tiago [1 ]
da Silva, Marcelo Silva [1 ]
Silva, Kleber Oliveira [1 ]
机构
[1] Pontificia Univ Catolica Parana, Lab Emerging Infect Dis, BR-80215901 Curitiba, Brazil
关键词
antimicrobial stewardship; rapid diagnostic methods; mHealth; eHealth; antimicrobial resistance; pharmacotherapeutic algorithms; BLOOD-STREAM INFECTIONS; INTENSIVE-CARE UNITS; ANTIBIOTIC-THERAPY; BACTEREMIA; COMMUNITY; IMPACT; SUSCEPTIBILITY; IDENTIFICATION; HOSPITALS; OUTCOMES;
D O I
10.3390/idr16040054
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
The urgent requirement for swift diagnostic methods in pathogen identification and antimicrobial susceptibility testing is emphasized by rising bacterial resistance and limited treatment options, which are particularly critical in sepsis management. The shift from traditional phenotype-based methods to rapid molecular and mass spectrometry techniques has significantly reduced result turnaround times, enhancing patient outcomes. In this systematic review with meta-analysis, the aspects of correct empirical antimicrobial therapy are evaluated to determine their impact on mortality. We performed a systematic review and meta-analysis on EMBASE, the Cochrane Library, Web of Science, and MEDLINE. Studies evaluating mortality associated with empirical adequate and inadequate therapy in different sites of infection were included. Outcomes included clinical cures in microbiologically evaluable patients. Among the sites of infection, the most studied were bloodstream infections (n = 9), followed by respiratory tract infections (n = 5), intra-abdominal infections (n = 5), and urinary tract infections (evaluated by 3 studies). Inadequate therapy was associated with an increase in mortality between 11 and 68%. Technologies to speed up pathogen identification are extremely necessary to reduce mortality.
引用
收藏
页码:707 / 723
页数:17
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