id	author	title	date	pages	extension	mime	words	sentences	flesch	summary	cache	txt
cord-011359-3lcjw873	De Waele, Jan J.	Antimicrobial de-escalation as part of antimicrobial stewardship in intensive care: no simple answers to simple questions—a viewpoint of experts	2020-02-05		.txt	text/plain	4816	205	29	It is most commonly recommended in the intensive care unit (ICU) patient who is treated with broad-spectrum antibiotics as a strategy to reduce antimicrobial pressure of empirical broad-spectrum therapy and prevent antimicrobial resistance, yet this has not been convincingly demonstrated in a clinical setting. In this manuscript, we aim to highlight recent insights into ADE, its value in ASPs and the practical application as well as discuss the controversies and Fig. 1 Schematic overview of the timeline of antimicrobial therapy including antimicrobial de-escalation, with the pivotal and companion antimicrobial components of the empirical regimen and most common changes within a short antibiotic course for critically ill patients with an infection. For example, when empirical treatment with meropenem is switched to levofloxacin, this may be considered as narrowing of the spectrum, but that patient is exposed to two courses of short duration antimicrobial therapy with a different -and potentially-cumulative damaging effect on the microbiome.	./cache/cord-011359-3lcjw873.txt	./txt/cord-011359-3lcjw873.txt