{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T17:35:07Z","timestamp":1794332107429,"version":"4.9.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"},{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infect Dis Ther"],"published-print":{"date-parts":[[2026,12]]},"DOI":"10.1007\/s40121-026-01437-x","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:02:07Z","timestamp":1790269327000},"page":"3321-3336","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond the Cumulative Antibiogram: A Weighted-Incidence Syndromic Combination Antibiogram to Guide Empirical Therapy of Bloodstream Infections in the Emergency Department"],"prefix":"10.1007","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9277-414X","authenticated-orcid":false,"given":"Celso Soares Pereira","family":"Batista","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5608-3090","authenticated-orcid":false,"given":"Laura","family":"Escol\u00e0-Verg\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4302-2838","authenticated-orcid":false,"given":"Ferran","family":"Navarro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9709-6162","authenticated-orcid":false,"given":"Alba","family":"Rivera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"1437_CR1","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1016\/J.CMI.2019.10.031","volume":"26","author":"WV Kern","year":"2020","unstructured":"Kern WV, Rieg S. Burden of bacterial bloodstream infection\u2014a brief update on epidemiology and significance of multidrug-resistant pathogens. Clin Microbiol Infect. 2020;26:151\u20137. https:\/\/doi.org\/10.1016\/J.CMI.2019.10.031.","journal-title":"Clin Microbiol Infect"},{"key":"1437_CR2","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1016\/S1473-3099(20)30477-1","volume":"21","author":"SS Kadri","year":"2021","unstructured":"Kadri SS, Lai YL, Warner S, et al. Inappropriate empirical antibiotic therapy for bloodstream infections based on discordant in-vitro susceptibilities: a retrospective cohort analysis of prevalence, predictors, and mortality risk in US hospitals. Lancet Infect Dis. 2021;21:241\u201351. https:\/\/doi.org\/10.1016\/S1473-3099(20)30477-1.","journal-title":"Lancet Infect Dis"},{"key":"1437_CR3","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-018-3524-8","author":"TP Lodise","year":"2018","unstructured":"Lodise TP, Zhao Q, Fahrbach K, Gillard PJ, Martin A. A systematic review of the association between delayed appropriate therapy and mortality among patients hospitalized with infections due to Klebsiella pneumoniae or Escherichia coli: how long is too long? BMC Infect Dis. 2018. https:\/\/doi.org\/10.1186\/s12879-018-3524-8.","journal-title":"BMC Infect Dis"},{"key":"1437_CR4","unstructured":"CLSI. Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test data; Approved Guideline\u2014Fourth Edition. CLSI document M39-A4. Wayne, PA: Clinical and Laboratory Standards Institute; 2014."},{"key":"1437_CR5","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1016\/j.eimc.2022.01.004","volume":"41","author":"MN Larrosa","year":"2023","unstructured":"Larrosa MN, Canut-Blasco A, Benito N, et al. Spanish Antibiogram Committee (COESANT) recommendations for cumulative antibiogram reports. Enferm Infecc Microbiol Clin. 2023;41:430\u20135.","journal-title":"Enferm Infecc Microbiol Clin"},{"key":"1437_CR6","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02210-21","author":"PJ Simner","year":"2022","unstructured":"Simner PJ, Hindler JA, Bhowmick T, et al. What\u2019s new in antibiograms? Updating CLSI M39 guidance with current trends. J Clin Microbiol. 2022. https:\/\/doi.org\/10.1128\/JCM.02210-21.","journal-title":"J Clin Microbiol"},{"key":"1437_CR7","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1086\/664768","volume":"33","author":"C Hebert","year":"2012","unstructured":"Hebert C, Ridgway J, Vekhter B, Brown EC, Weber SG, Robicsek A. Demonstration of the Weighted-Incidence Syndromic Combination Antibiogram: an empiric prescribing decision aid. Infect Control Hosp Epidemiol. 2012;33:381\u20138. https:\/\/doi.org\/10.1086\/664768.","journal-title":"Infect Control Hosp Epidemiol"},{"key":"1437_CR8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0214710","author":"Z Tandogdu","year":"2006","unstructured":"Tandogdu Z, Kakariadis ETA, Naber K, Wagenlehner F, Johansen TEB. Appropriate empiric antibiotic choices in health care associated urinary tract infections in urology departments in Europe from 2006 to 2015: a Bayesian analytical approach applied in a surveillance study. PLoS ONE. 2006. https:\/\/doi.org\/10.1371\/journal.pone.0214710.","journal-title":"PLoS ONE"},{"key":"1437_CR9","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1080\/14787210.2021.1967145","volume":"20","author":"A Cook","year":"2022","unstructured":"Cook A, Sharland M, Yau Y, Group PB, Bielicki J. Improving empiric antibiotic prescribing in pediatric bloodstream infections: a potential application of weighted-incidence syndromic combination antibiograms (WISCA). Expert Rev Anti Infect Ther. 2022;20:445\u201356. https:\/\/doi.org\/10.1080\/14787210.2021.1967145.","journal-title":"Expert Rev Anti Infect Ther"},{"key":"1437_CR10","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2023.1124165","author":"A Cook","year":"2023","unstructured":"Cook A, Atkinson A, Kronenberg A, et al. Estimating antibiotic coverage from linked microbiological and clinical data from the Swiss Paediatric Sepsis Study to support empiric antibiotic regimen selection. Front Pediatr. 2023. https:\/\/doi.org\/10.3389\/fped.2023.1124165.","journal-title":"Front Pediatr"},{"key":"1437_CR11","doi-asserted-by":"publisher","first-page":"794","DOI":"10.1093\/jac\/dkv397","volume":"71","author":"JA Bielicki","year":"2016","unstructured":"Bielicki JA, Sharland M, Johnson AP, et al. Selecting appropriate empirical antibiotic regimens for paediatric bloodstream infections: application of a Bayesian decision model to local and pooled antimicrobial resistance surveillance data. J Antimicrob Chemother. 2016;71:794\u2013802. https:\/\/doi.org\/10.1093\/jac\/dkv397.","journal-title":"J Antimicrob Chemother"},{"key":"1437_CR12","doi-asserted-by":"publisher","DOI":"10.1186\/s12941-024-00673-8","volume":"23","author":"C Liberati","year":"2024","unstructured":"Liberati C, Don\u00e0 D, Maestri L, et al. Application of the weighted-incidence syndromic combination antibiogram (WISCA) to guide the empiric antibiotic treatment of febrile neutropenia in oncological paediatric patients: experience from two paediatric hospitals in Northern Italy. Ann Clin Microbiol Antimicrob. 2024;23:16. https:\/\/doi.org\/10.1186\/s12941-024-00673-8.","journal-title":"Ann Clin Microbiol Antimicrob"},{"key":"1437_CR13","doi-asserted-by":"publisher","DOI":"10.1186\/cc13901","volume":"18","author":"V Randhawa","year":"2014","unstructured":"Randhawa V, Sarwar S, Walker S, Elligsen M, Palmay L, Daneman N. Weighted-incidence syndromic combination antibiograms to guide empiric treatment of critical care infections: a retrospective cohort study. Crit Care. 2014;18:R112. https:\/\/doi.org\/10.1186\/cc13901.","journal-title":"Crit Care"},{"key":"1437_CR14","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-025-10677-0","volume":"25","author":"J Briseno-Ram\u00edrez","year":"2025","unstructured":"Briseno-Ram\u00edrez J, G\u00f3mez-Quiroz A, Avila-Cardenas BB, et al. Development of a weighted-incidence syndromic combination antibiogram (WISCA) to guide empiric antibiotic treatment for ventilator-associated pneumonia in a Mexican tertiary care university hospital. BMC Infect Dis. 2025;25:307. https:\/\/doi.org\/10.1186\/s12879-025-10677-0.","journal-title":"BMC Infect Dis"},{"key":"1437_CR15","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1017\/ICE.2025.10391","volume":"47","author":"L Noelle Taylor","year":"2026","unstructured":"Noelle Taylor L, Gangnon R, Howe M, et al. Optimizing facility-specific urinary weighted-incidence syndromic antibiograms for nursing homes. Infect Control Hosp Epidemiol. 2026;47:311\u20137. https:\/\/doi.org\/10.1017\/ICE.2025.10391.","journal-title":"Infect Control Hosp Epidemiol"},{"key":"1437_CR16","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmicom.2025.105170","volume":"3","author":"M Dhaliwal","year":"2026","unstructured":"Dhaliwal M, Elligsen M, Lam PW, Daneman N. Weighted-incidence syndromic combination antibiogram to guide antibiotic regimens for empiric treatment of prosthetic joint infections: a retrospective cohort study. CMI Commun. 2026;3:105170. https:\/\/doi.org\/10.1016\/j.cmicom.2025.105170.","journal-title":"CMI Commun"},{"key":"1437_CR17","doi-asserted-by":"publisher","first-page":"14","DOI":"10.3390\/ANTIBIOTICS14020187","volume":"14","author":"A G\u00f3mez-Quiroz","year":"2025","unstructured":"G\u00f3mez-Quiroz A, Avila-Cardenas BB, De Arcos-Jim\u00e9nez JC, Perales-Guerrero L, Mart\u00ednez-Ayala P, Briseno-Ramirez J. The clinical implications of inappropriate therapy in community-onset urinary tract infections and the development of a Bayesian hierarchical weighted-incidence syndromic combination antibiogram. Antibiotics. 2025;14:14. https:\/\/doi.org\/10.3390\/ANTIBIOTICS14020187. (Epub ahead of print February 12).","journal-title":"Antibiotics"},{"key":"1437_CR18","doi-asserted-by":"publisher","first-page":"E265","DOI":"10.1093\/cid\/ciaa1048","volume":"72","author":"JP Ridgway","year":"2021","unstructured":"Ridgway JP, Robicsek A, Shah N, et al. A randomized controlled trial of an electronic clinical decision support tool for inpatient antimicrobial stewardship. Clin Infect Dis. 2021;72:E265\u201371. https:\/\/doi.org\/10.1093\/cid\/ciaa1048.","journal-title":"Clin Infect Dis"},{"key":"1437_CR19","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1016\/j.cmi.2020.01.024","volume":"26","author":"M Paul","year":"2020","unstructured":"Paul M, Huttner A, Bielicki JA, et al. Reporting methods of observational cohort studies in CMI. Clin Microbiol Infect. 2020;26:395\u20138. https:\/\/doi.org\/10.1016\/j.cmi.2020.01.024.","journal-title":"Clin Microbiol Infect"},{"key":"1437_CR20","unstructured":"The European Committee on Antimicrobial Susceptibility Testing. Expected Resistant Phenotypes Version 1.2 January 2023. https:\/\/www.eucast.org\/."},{"key":"1437_CR21","doi-asserted-by":"publisher","first-page":"791","DOI":"10.7326\/0003-4819-137-10-200211190-00007","volume":"137","author":"ND Friedman","year":"2002","unstructured":"Friedman ND, Kaye KS, Stout JE, et al. Health care\u2013associated bloodstream infections in adults: a reason to change the accepted definition of community-acquired infections. Ann Intern Med. 2002;137:791\u20137. https:\/\/doi.org\/10.7326\/0003-4819-137-10-200211190-00007.","journal-title":"Ann Intern Med"},{"key":"1437_CR22","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofy116","volume":"5","author":"DN Friedman","year":"2018","unstructured":"Friedman DN, Levit D, Taleb E, et al. Towards a definition for health care\u2013associated infection. Open Forum Infect Dis. 2018;5:ofy116. https:\/\/doi.org\/10.1093\/ofid\/ofy116.","journal-title":"Open Forum Infect Dis"},{"key":"1437_CR23","unstructured":"The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 14.0, 2024. http:\/\/www.eucast.org."},{"key":"1437_CR24","unstructured":"The European Committee on Antimicrobial Susceptibility Testing. EUCAST guidelines for detection of resistance mechanisms and specific resistances of clinical and\/or epidemiological importance. Version 2.0. 2017; Available at: http:\/\/www.eucast.org. Accessed 1 February 2025."},{"key":"1437_CR25","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","volume":"18","author":"AP Magiorakos","year":"2012","unstructured":"Magiorakos AP, Srinivasan A, Carey RB, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012;18:268\u201381. https:\/\/doi.org\/10.1111\/j.1469-0691.2011.03570.x.","journal-title":"Clin Microbiol Infect"},{"key":"1437_CR26","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1093\/cid\/ciy1031","volume":"69","author":"AM Cressman","year":"2019","unstructured":"Cressman AM, Macfadden DR, Verma AA, Razak F, Daneman N. Empiric antibiotic treatment thresholds for serious bacterial infections: a scenario-based survey study. Clin Infect Dis. 2019;69:930\u20137. https:\/\/doi.org\/10.1093\/cid\/ciy1031.","journal-title":"Clin Infect Dis"}],"container-title":["Infectious Diseases and Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40121-026-01437-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40121-026-01437-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40121-026-01437-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T16:45:37Z","timestamp":1794329137000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40121-026-01437-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,24]]},"references-count":26,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2026,12]]}},"alternative-id":["1437"],"URL":"https:\/\/doi.org\/10.1007\/s40121-026-01437-x","relation":{},"ISSN":["2193-8229","2193-6382"],"issn-type":[{"value":"2193-8229","type":"print"},{"value":"2193-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,24]]},"assertion":[{"value":"22 July 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Celso Soares Pereira Batista, Laura Escol\u00e0-Verg\u00e9, Ferran Navarro and Alba Rivera declare that they have no conflicts of interest.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the Ethics Committee of Hospital de la Santa Creu i Sant Pau (IIBSP-WIS-2022-144; April 17, 2024). and conducted in accordance with the Declaration of Helsinki and European data protection regulations. The requirement for informed consent was waived by the ethics committee due to the retrospective observational design of the study.","order":2,"name":"Ethics","label":"Ethical Approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}