Definitions
De-escalation therapy: De-escalation therapy was defined as either a switch to a narrower spectrum agent or the reduction in the number of antibiotics or the early arrest of antibiotic treatment [13]. The guidelines recommend that using broad-spectrum antibiotics when the pathogen is not identified [12], otherwise using narrow-spectrum antibiotics. In our study, antibiotic de-escalation therapy is defined as the use of broad-spectrum antibiotic (imipenem) for the first 3 days and then switch to narrow-spectrum antibiotic (ceftriaxone) according to previous research [4, 13], because the bacterial culture results usually take 48-72h to obtain.
Escalation therapy: Escalation therapy is the opposite of de-escalation therapy. In our study, we defined escalation therapy as the use of narrow-spectrum antibiotic (ceftriaxone) in the first three days of sepsis, followed by broad-spectrum antibiotic (imipenem).