1. A JC is an academic session where we go through a scientific article for 1 hour.
2. It takes place every Friday.
3. Its purpose is to understand and discuss relevant elements about the content taking interactive and pedagogic notes (highlighting, underlining and using other learning resources) about the content.
4. We generate further appraisal, identify the opportunities of learning and formulate some potential research questions.
5. We write down the key-points of every session and publish them on our website
6. The article for the next session is posted one week in advance the must-read JC channel of our DISCORD server.
โณ TIME MANAGEMENT.
01:02:41
Round: 2 22:12:52 Wrap-up
Round: 1 40:28:71 Article 1
โณ TIME MANAGEMENT.
01:02:41
Round: 6 02:27:50 Comments
Round: 5 13:37:72 Comments
Round: 4 49:15:51 Evidence
Round: 3 19:40:68 Scope
Round: 2 01:46:38 ART selection
Round: 1 04:57:22 Past JC
โณ TIME MANAGEMENT.
01:02:41
Round: 5 00:01:73 Final words
Round: 4 16:04:42 Wrap-up
Round: 3 01:27:41 ART
Round: 2 07:08:47 ART selection
Round: 1 04:18:24 Past JC
Codified by RICH
Glossary: ๐ชฒ = infection; ADE = antibiotic de-escalation; ATB = antibiotic; ICU = intensive care unit; IPW = inverse probability weighting; MDR = multidrug resistance; MM28 = mortality at 28 days; OBS = observational; pros_ = prospective; RCT = randomized controlled trial;
1. ๐๐๐พ BS โฉ Y, J, C โ T โ N โ t โ P I C O:
2. ๐๐๐พ BS ๐ฐ 2020, ICM, BE โ pros_OBS โ <1500 (152 ICU), 28 countriesโ 2y (2016 - 2018) โ P I C O:
- P: adults, ICU w_ATB
- I: ADE ๐ no change ๐ changes other than ADE
- C: NA
- O: a. how often ADE is used. b. Estimate effect on clinical cure on D7
3. EVIDENCE:
- The aim of ADE is โ use of broad - spectrum ATB use (a. โ spectrum b. Stopping) to
CONTAIN MDR
- ADE = INTERNATIONALLY RECOGNIZED as a key component of antimicrobial
stewardship
- Lack of info on MAPPING COMPLETE ATB TTO
- ADE ๐ฐOBS (โ MM) ๐ RCT (lack of convincing evidence of safety)
4. METHODS.
- ADE โ (1) discontinuation of ATB if empirical combination therapy or (2) replacement of an ATB with the intention to narrow the spectrum (first 3 days of therapy).
- INTERV โ
- DEF. Empirical โโ=โ UNIDENTIFED pathogen and susceptibility pattern at start of ATB.
- IN. adults โ ICU โ at least 48h (anticipated need of ICU) โ (community, healthcare,
H+, ICU) bacterial INF
- DEF presence. MDR on ICU admission of before D2
- DEF emergence. MDR โ D2 and D28.
- DEF. MDR = ESBL or carbapenemase OR Stenotrophomonas maltophilia OR methicillin-
resistant Staphylococcus aureus OR vancomycin-resistant Enterococcus sp. OR pathogen
resistant to โฅ3 antimicrobial classes.
- DEF Clinical cure = as SS and resolution of all signs and symptoms related to the INF under study
6. RESULTS
- Combination โฉ 50%
- Carbapenems โฉ 26%
- Frequency ofโฆ In the first 3 days:
* ADE = 16%
* No change = 63%
* Change other than ADE = 22%
- MM28 โฉ ADE 16% ๐ no change 19% (p=0.27)
- Clinical cure โฉ [IP-weighted relative risk estimate] โฉ ADE ๐ no-ADE = 1.37
โณ TIME MANAGEMENT.
59:04:93
Round: 3 00:34:58 Comments
Round: 2 54:56:36 JC
Round: 1 03:33:98 Past JC
Friday, Dec 27, 2024 at 18h30 at BO - 23h30 at BE
MAAT, RICH, HIBN, GMC, AHO, AAQC
Codified by RICH
Glossary: ๐= infection; IPW = inverse probability weighting; MM28 = mortality at 28 days; OBS = observational; pros_ = prospective; RCT = randomized controlled trial; ADE = antibiotic de-escalation; ICU = intensive care unit;
1. ๐๐๐พ BS โฉ Y, J, C โ T โ N โ t โ P I C O:
2. ๐๐๐พ BS ๐ฐ 2020, ICM, BE โ pros_OBS โ <1500 โ 2y (2016 - 2018) โ P I C O:
- P: adults, ICU w_ATB
- I: ADE ๐ no change ๐ changes other than ADE
- C: NA
- O: a. how often ADE is used. b. Estimate effect on clinical cure on D7
3. EVIDENCE: โฆwaiting for JCAU and AHOโฆ
4. METHODS.
- ADE โ (1) discontinuation of ATB if empirical combination therapy or (2) replacement of an
ATB with the intention to narrow the spectrum (first 3 days of therapy).
- INTERV โ to continue...
6. RESULTS
7. RATIONALE
8. LIMITATIONS
โณ TIME MANAGEMENT.
01:13:17
Round: 3 11:42:67 Comments
Round: 2 50:57:40 ART + wrap-up
Round: 1 10:36:93 Past JC
Glossary (most used)
โ = increase, โ = decrease,โ๏ธ = improve,โ๏ธ = worsen, ๐๐ซ = exclusion, ๐๐ก = inclusion, โ = recommendation(s), ๐ฃ = suggestion(s), critILL = critically ill, DX = diagnosis, h_LOS = Hospital length of stay, icu_LOS = ICU length of stay, inc_ = incident, MA = metaanalysis, mc = multicentric, MM = mortality, MM90 = mortality at 90 days, pxs = patients, pOC = primary outcome(s), sOC = secondary outcome(s), SS = survival, w_ = with, wo_ = without, RCT = randomized controlled trial, sr = systematic review, yo = years old.
Brief scope glossary
- ๐๐๐พ BS ๐ฐ ๐๐๐ผ๐ผ๐๐พ แดฎแดผ brief scope โฉ
- Y, J, C โ T โ N โ t โ P I C O: โฉ
- year (Y), journal (J), country (C) โ type of study (T) โ number of patients/sample (N) โ time (t) โ population (P),
intervention (I), comparison (C), outcome (O, OC).
Complete glossary here
