{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T20:14:02Z","timestamp":1784837642942,"version":"3.55.0"},"reference-count":24,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/100006510","name":"Duke University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006510","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Critical Care"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1016\/j.jcrc.2026.155646","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T13:44:55Z","timestamp":1780321495000},"page":"155646","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Antibiotic De-escalation and 30-day mortality in patients with suspected bacterial culture-negative Sepsis"],"prefix":"10.1016","volume":"95","author":[{"given":"Tetsu","family":"Ohnuma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Fuller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poojitha","family":"Balamurugan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebekah","family":"Moehring","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay","family":"Krishnamoorthy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthik","family":"Raghunathan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam M.","family":"Treggiari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"11","key":"10.1016\/j.jcrc.2026.155646_bb0005","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1007\/s00134-021-06506-y","article-title":"Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021","volume":"47","author":"Evans","year":"2021","journal-title":"Intensive Care Med"},{"issue":"1","key":"10.1016\/j.jcrc.2026.155646_bb0010","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1186\/s13054-021-03592-8","article-title":"Comparison of culture-negative and culture-positive sepsis or septic shock: a systematic review and meta-analysis","volume":"25","author":"Li","year":"2021","journal-title":"Crit Care"},{"issue":"7","key":"10.1016\/j.jcrc.2026.155646_bb0015","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofad286","article-title":"Early discontinuation of antibiotics in patients admitted with clinically suspected serious infection but negative cultures: retrospective cohort study of practice patterns and outcomes at 111 US hospitals","volume":"10","author":"Kadri","year":"2023","journal-title":"Open Forum Infect Dis"},{"issue":"1","key":"10.1016\/j.jcrc.2026.155646_bb0020","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.chest.2018.10.014","article-title":"Outcomes associated with De-escalating therapy for methicillin-resistant Staphylococcus aureus in culture-negative nosocomial pneumonia","volume":"155","author":"Cowley","year":"2019","journal-title":"Chest"},{"issue":"10","key":"10.1016\/j.jcrc.2026.155646_bb0025","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1007\/s00134-014-3411-8","article-title":"De-escalation versus continuation of empirical antimicrobial treatment in severe sepsis: a multicenter non-blinded randomized noninferiority trial","volume":"40","author":"Leone","year":"2014","journal-title":"Intensive Care Med"},{"issue":"2","key":"10.1016\/j.jcrc.2026.155646_bb0030","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/s00134-019-05866-w","volume":"46","author":"Tabah","year":"2020","journal-title":"Intensive Care Med"},{"issue":"8","key":"10.1016\/j.jcrc.2026.155646_bb0035","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1093\/cid\/civ1199","article-title":"A systematic review of the definitions, determinants, and clinical outcomes of antimicrobial De-escalation in the intensive care unit","volume":"62","author":"Tabah","year":"2016","journal-title":"Clin Infect Dis"},{"issue":"3","key":"10.1016\/j.jcrc.2026.155646_bb0040","first-page":"CD007934","article-title":"De-escalation of antimicrobial treatment for adults with sepsis, severe sepsis or septic shock","author":"Silva","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"issue":"49","key":"10.1016\/j.jcrc.2026.155646_bb0045","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000023385","article-title":"Efficacy and safety of antimicrobial de-escalation of treatment for sepsis: a protocol for systematic review and meta-analysis","volume":"99","author":"Zhu","year":"2020","journal-title":"Medicine (Baltimore)"},{"issue":"2","key":"10.1016\/j.jcrc.2026.155646_bb0050","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1080\/14787210.2019.1561275","article-title":"Efficacy and safety of antimicrobial de-escalation as a clinical strategy","volume":"17","author":"Mathieu","year":"2019","journal-title":"Expert Rev Anti Infect Ther"},{"issue":"1","key":"10.1016\/j.jcrc.2026.155646_bb0055","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1007\/s00134-013-3077-7","article-title":"De-escalation of empirical therapy is associated with lower mortality in patients with severe sepsis and septic shock","volume":"40","author":"Garnacho-Montero","year":"2014","journal-title":"Intensive Care Med"},{"issue":"9","key":"10.1016\/j.jcrc.2026.155646_bb0060","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1097\/CCM.0000000000005870","article-title":"Epidemiology, resistance profiles, and outcomes of bloodstream infections in community-onset Sepsis in the United States","volume":"51","author":"Ohnuma","year":"2023","journal-title":"Crit Care Med"},{"issue":"2","key":"10.1016\/j.jcrc.2026.155646_bb0065","article-title":"Association of causative pathogens with acute kidney injury in adult patients with community-onset sepsis","volume":"7","author":"Pant","year":"2025","journal-title":"Crit Care Explor"},{"issue":"1","key":"10.1016\/j.jcrc.2026.155646_bb0070","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1186\/s13054-024-05151-3","article-title":"Culture-negative sepsis may be a different entity from culture-positive sepsis: a prospective nationwide multicenter cohort study","volume":"28","author":"Chang","year":"2024","journal-title":"Crit Care"},{"issue":"3","key":"10.1016\/j.jcrc.2026.155646_bb0075","article-title":"Antibiotic de-escalation in critically ill patients with negative clinical cultures","volume":"11","author":"Roper","year":"2023","journal-title":"Pharmacy (Basel)"},{"issue":"11","key":"10.1016\/j.jcrc.2026.155646_bb0080","doi-asserted-by":"crossref","DOI":"10.1093\/cid\/ciaa932","article-title":"Development of an electronic definition for de-escalation of antibiotics in hospitalized patients","volume":"73","author":"Moehring","year":"2021","journal-title":"Clin Infect Dis"},{"issue":"7","key":"10.1016\/j.jcrc.2026.155646_bb0085","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1007\/s00134-020-06111-5","article-title":"Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study","volume":"46","author":"De Bus","year":"2020","journal-title":"Intensive Care Med"},{"issue":"7","key":"10.1016\/j.jcrc.2026.155646_bb0090","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1097\/MLR.0000000000000735","article-title":"Identifying increased risk of readmission and in-hospital mortality using hospital administrative data: the AHRQ Elixhauser comorbidity index","volume":"55","author":"Moore","year":"2017","journal-title":"Med Care"},{"issue":"8","key":"10.1016\/j.jcrc.2026.155646_bb0095","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The third international consensus definitions for Sepsis and septic shock (Sepsis-3)","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA"},{"issue":"2","key":"10.1016\/j.jcrc.2026.155646_bb0100","doi-asserted-by":"crossref","DOI":"10.1186\/cc10072","article-title":"Impact of de-escalation therapy on clinical outcomes for intensive care unit-acquired pneumonia","volume":"15","author":"Joung","year":"2011","journal-title":"Crit Care"},{"issue":"4","key":"10.1016\/j.jcrc.2026.155646_bb0105","doi-asserted-by":"crossref","DOI":"10.1186\/cc12819","article-title":"Factors influencing the implementation of antibiotic de-escalation and impact of this strategy in critically ill patients","volume":"17","author":"Gonzalez","year":"2013","journal-title":"Crit Care"},{"issue":"1","key":"10.1016\/j.jcrc.2026.155646_bb0110","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1093\/cid\/ciae591","article-title":"Epidemiology and outcomes of antibiotic de-escalation in patients with suspected sepsis in US hospitals","volume":"80","author":"Kam","year":"2025","journal-title":"Clin Infect Dis"},{"issue":"5","key":"10.1016\/j.jcrc.2026.155646_bb0115","first-page":"473","article-title":"Culture-negative sepsis","volume":"26","author":"Thorndike","year":"2020","journal-title":"Curr Opin Crit Care"},{"issue":"2","key":"10.1016\/j.jcrc.2026.155646_bb0120","doi-asserted-by":"crossref","DOI":"10.5492\/wjccm.v14.i2.101587","article-title":"Sepsis in liver failure patients: diagnostic challenges and recent advancements","volume":"14","author":"Kumar","year":"2025","journal-title":"World J Crit Care Med"}],"container-title":["Journal of Critical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0883944126002248?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0883944126002248?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T19:45:42Z","timestamp":1784835942000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0883944126002248"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":24,"alternative-id":["S0883944126002248"],"URL":"https:\/\/doi.org\/10.1016\/j.jcrc.2026.155646","relation":{},"ISSN":["0883-9441"],"issn-type":[{"value":"0883-9441","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Antibiotic De-escalation and 30-day mortality in patients with suspected bacterial culture-negative Sepsis","name":"articletitle","label":"Article Title"},{"value":"Journal of Critical Care","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jcrc.2026.155646","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"155646"}}