Meyer 2007.
| Methods | Study design: ITS | |
| Participants | Physicians Clinical speciality: general practice/family medicine Level of training: fully trained Setting/country: outpatient (e.g. ambulatory care provided by hospitals/specialists)/Germany |
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| Interventions | Revised guidelines on empirical antibiotic treatment in the ICU: the written guidelines on empirical antibiotic treatment in the ICU were revised in December 2003 upon publication of the study by Chastre et al (Chastre 2003). and with respect to the local resistance situation. This change of empirical therapy was performed by a multidisciplinary team consisting of the intensive care specialist responsible for the ward and an infection control physician, and occasionally included also a microbiologist and a pharmacist | |
| Outcomes | 1 process outcome: antibiotic use density (AD; expressed as defined daily doses per 1000 patient‐days) | |
| Notes | ‐ | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Intervention independent of other changes ‐ ITS | Unclear risk | No information was provided |
| Shape of Intervention effect pre‐specified ‐ ITS | Low risk | Quote, pg. 1148: "to evaluate the impact of an intervention to reduce the duration of antibiotic treatment for pneumonia in a neurosurgical intensive care unit (ICU). The usage of antibiotics and the resultant costs were examined using interrupted time series analysis while resistance and device‐associated infection rates are also described" |
| Intervention unlikely to affect data collection ‐ ITS | Low risk | The intervention (written guidelines) did not affect the source or method of data collection |
| Blinding of outcome assessors (detection bias) ‐ ITS All outcomes | Low risk | The outcome was objective |
| Incomplete outcome data (attrition bias) ‐ ITS All outcomes | Low risk | Quote, pg. 1149: "monthly data on antimicrobial usage and costs of antibiotics were obtained from the computerized pharmacy database" COMMENT: missing data, if any, is likely similar pre‐ and post‐intervention |
| Selective reporting (reporting bias) ‐ ITS | Low risk | All relevant outcomes in the methods section were reported in the results section |
| Other bias ‐ ITS | Low risk | There was no evidence of other risks of bias |