{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:42:48Z","timestamp":1783507368536,"version":"3.55.0"},"reference-count":24,"publisher":"Korean Association of Internal Medicine","issue":"5","license":[{"start":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T00:00:00Z","timestamp":1692230400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"funder":[{"DOI":"10.13039\/501100008126","name":"Jeju National University Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008126","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["kjim.org"],"crossmark-restriction":true},"short-container-title":["Korean J Intern Med"],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"<jats:p>Background\/Aims: Antimicrobial de-escalation (ADE) remains a challenging strategy in the treatment of pneumonia. We investigated the outcomes of ADE as measured by mortality and duration of the use of antibiotics in patients with culture- negative pneumonia.Methods: We performed a systematic review and meta-analysis in accordance with PRISMA guidelines. The primary outcome was inpatient mortality.Results: We examined six studies comprising 11,933 subjects, of whom 1,152 received ADE. Overall, the ADE strategy was associated with a statistically lower risk of in-hospital mortality compared with non-ADE (risk ratio [RR] = 0.60, 95% confidence interval [CI] = 0.38 to 0.93). Although substantial heterogeneity was found among the included studies (I&lt;i&gt;2&lt;\/i&gt; = 66%), a meta-regression analysis could not reveal plausible sources of heterogeneity. And ADE was associated with a shorter duration of total and initial antibiotic therapies and total length of hospital stay compared with non-ADE.Conclusions: Our findings suggest that ADE seems to be significantly associated with better clinical outcomes compared with non-ADE. Caution is demanded when interpreting data of this study because of substantial between-study heterogeneity.<\/jats:p>","DOI":"10.3904\/kjim.2023.115","type":"journal-article","created":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T00:48:26Z","timestamp":1692233306000},"page":"704-713","update-policy":"https:\/\/doi.org\/10.3904\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The impact of antimicrobial de-escalation therapy in culture-negative pneumonia: a systematic review and meta-analysis"],"prefix":"10.3904","volume":"38","author":[{"given":"Jae-Uk","family":"Song","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2626-7099","authenticated-orcid":true,"given":"Jonghoo","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2270","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw353"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-14-13"},{"key":"ref3","first-page":"1404","volume-title":"Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study","author":"De Bus","year":"2020"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-013-3077-7"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1097\/01.ccm.0000145997.10438.28"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1378\/chest.129.5.1210"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1186\/cc13022"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1500245"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1186\/cc12896"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-1652"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ1199"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-151-4-200908180-00135"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2018.10.014"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa212"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1186\/cc10072"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2019.06.026"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0b013e318287f713"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-010-0042-z"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201908-1581st"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2015.02.003"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkr137"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00057-2019"}],"container-title":["The Korean Journal of Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/kjim.org\/upload\/kjim-2023-115.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/kjim.org\/journal\/view.php?doi=10.3904\/kjim.2023.115","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/kjim.org\/upload\/kjim-2023-115.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T07:56:14Z","timestamp":1694073374000},"score":1,"resource":{"primary":{"URL":"http:\/\/kjim.org\/journal\/view.php?doi=10.3904\/kjim.2023.115"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,1]]},"references-count":24,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,9]]}},"URL":"https:\/\/doi.org\/10.3904\/kjim.2023.115","relation":{},"ISSN":["1226-3303","2005-6648"],"issn-type":[{"value":"1226-3303","type":"print"},{"value":"2005-6648","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,1]]},"assertion":[{"value":"2023-03-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-17","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-01","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}