@article{3107034,
    title = "Antibiotic treatment of infections caused by carbapenem-resistant Gram-negative bacilli: an international ESCMID cross-sectional survey among infectious diseases specialists practicing in large hospitals",
    author = "Papst, L. and Beovic, B. and Pulcini, C. and Durante-Mangoni, E. and Rodríguez-Baño, J. and Kaye, K.S. and Daikos, G.L. and Raka, L. and Paul, M. and Abbo, L. and Abgueguen, P. and Almirante, B. and Azzini, A.M. and Bani-Sadr, F. and Bassetti, M. and Ben-Ami, R. and Béraud, G. and Botelho-Nevers, E. and Bou, G. and Boutoille, D. and Cabié, A. and Cacopardo, B. and Cascio, A. and Cassir, N. and Castelli, F. and Cecala, M. and Charmillon, A. and Chirouze, C. and Cisneros, J.M. and Colmenero, J.D. and Coppola, N. and Corcione, S. and Dalla Gasperina, D. and De la Calle Cabrera, C. and Delobel, P. and Di Caprio, D. and Dupon, M. and Ettahar, N. and Falagas, M.E. and Falcone, M. and Fariñas, M.C. and Faure, E. and Forestier, E. and Foti, G. and Gallagher, J. and Gattuso, G. and Gendrin, V. and Gentile, I. and Giacobbe, D.R. and Gogos, C.A. and Grandiere Perez, L. and Hansmann, Y. and Horcajada, J.P. and Iacobello, C. and Jacob, J.T. and Justo, J.A. and Kernéis, S. and Komnos, A. and Kotnik Kevorkijan, B. and Lebeaux, D. and Le Berre, R. and Lechiche, C. and Le Moxing, V. and Lescure, F.X. and Libanore, M. and Martinot, M. and Merino de Lucas, E. and Mondain, V. and Mondello, P. and Montejo, M. and Mootien, J. and Muñoz, P. and Nir-Paz, R. and Pan, A. and Paño-Pardo, J.R. and Patel, G. and Pérez Rodríguez, M.T. and Piroth, L. and Pogue, J. and Potoski, B.A. and Pourcher, V. and Pyrpasopoulou, A. and Rahav, G. and Rizzi, M. and Salavert, M. and Scheetz, M. and Sims, M. and Spahija, G. and Stefani, S. and Stefos, A. and Tamma, P.D. and Tattevin, P. and Tedesco, A. and Torre-Cisneros, J. and Tripolitsioti, P. and Tsiodras, S. and Uomo, G. and Verdon, R. and Viale, P. and Vitrat, V. and Weinberger, M. and Wiener-Well, Y. and ESGAP, ESGBIS, ESGIE and the CRGNB treatment survey study group",
    journal = "Clinical Microbiology and Infection",
    year = "2018",
    volume = "24",
    number = "10",
    pages = "1070-1076",
    publisher = "Elsevier B.V.",
    issn = "1198-743X",
    doi = "10.1016/j.cmi.2018.01.015",
    keywords = "aminoglycoside;  avibactam plus ceftazidime;  carbapenem;  ceftolozane plus tazobactam;  doripenem;  ertapenem;  fosfomycin;  imipenem;  meropenem;  polymyxin;  rifampicin;  tigecycline;  antiinfective agent;  carbapenem derivative, abdominal infection;  Acinetobacter baumannii;  adult;  antibiotic therapy;  Article;  bacteremia;  carbapenem-resistant Enterobacteriaceae;  central nervous system infection;  cross-sectional study;  emergency care;  France;  Gram negative bacterium;  Greece;  hospital infection;  human;  infectious disease specialist;  Israel;  Italy;  Kosovo;  major clinical study;  monotherapy;  pneumonia;  priority journal;  Pseudomonas aeruginosa;  skin infection;  Slovenia;  soft tissue infection;  Spain;  structured questionnaire;  tertiary health care;  urinary tract infection;  antibiotic resistance;  cross infection;  drug effect;  Gram negative bacterium;  Gram negative infection;  hospital;  microbial sensitivity test;  microbiology;  questionnaire, Anti-Bacterial Agents;  Carbapenems;  Cross Infection;  Cross-Sectional Studies;  Drug Resistance, Bacterial;  Gram-Negative Bacteria;  Gram-Negative Bacterial Infections;  Hospitals;  Humans;  Microbial Sensitivity Tests;  Surveys and Questionnaires",
    abstract = "Objectives: To explore contemporary antibiotic management of infections caused by carbapenem-resistant Gram-negative bacteria in hospitals. Methods: Cross-sectional, internet-based questionnaire survey. We contacted representatives of all hospitals with more than 800 acute-care hospital beds in France, Greece, Israel, Italy, Kosovo, Slovenia, Spain and selected hospitals in the USA. We asked respondents to describe the most common actual practice at their hospital regarding management of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa through close-ended questions. Results: Between January and June 2017, 115 of 141 eligible hospitals participated (overall response rate 81.6%, country-specific rates 66.7%–100%). Most were tertiary-care (99/114, 86.8%), university-affiliated (110/115, 89.1%) hospitals and most representatives were infectious disease specialists (99/115, 86.1%). Combination therapy was prescribed in 114/115 (99.1%) hospitals at least occasionally. Respondents were more likely to consider combination therapy when treating bacteraemia, pneumonia and central nervous system infections and for Enterobacteriaceae, P. aeruginosa and A. baumannii similarly. Combination of a polymyxin with a carbapenem was used in most cases, whereas combinations of a polymyxin with tigecycline, an aminoglycoside, fosfomycin or rifampicin were also common. Monotherapy was used for treatment of complicated urinary tract infections, usually with an aminoglycoside or a polymyxin. The intended goal of combination therapy was to improve the effectiveness of the treatment and to prevent development of resistance. In general, respondents shared the misconception that combination therapy is supported by strong scientific evidence. Conclusions: Combination therapy was the preferred treatment strategy for infections caused by carbapenem-resistant Gram-negative bacteria among hospital representatives, even though high-quality evidence for carbapenem-based combination therapy is lacking. © 2018 European Society of Clinical Microbiology and Infectious Diseases"
}