Impact of appropriate antimicrobial therapy on patient outcomes and antimicrobial use: a sub analysis of the DIANA Study Dataset
Authors' conclusion
In critically ill ICU patients, appropriate empirical antimicrobial therapy is independently associated with reduced 28-day mortality rates.
Study context
- Population
- Adult ICU patients receiving empirical antimicrobials for microbiologically confirmed bacterial infection
- Participants
- 845 microbiologically confirmed infections
- Comparison
- Appropriate vs inappropriate empirical antimicrobial therapy
- Primary endpoint
- 28-day mortality
- Follow-up
- 28 days
Methodological detailsinternational ICU cohort, predefined sub-analysis, multivariable logistic and Cox regression, pre-specified interaction analyses
- International ICU cohort
- Predefined sub-analysis
- Multivariable logistic and Cox regression
- Pre-specified interaction analyses
Primary result
As reported in the abstract
Appropriate vs InappropriateEstimate (95% CI)P value
Reported as associated with reduced 28-day mortality
aOR 1.83(1.11–3.06)
P = 0.0228-day mortality
HR 1.51(1.03–2.21)
P = 0.035Further findings
- Prevalence of appropriate empirical therapy
- 87.7%
ICU mortality, 28-day antimicrobial-free days and mechanical ventilation-free days
- Appropriate therapy associated with significantly lower ICU mortality and longer antimicrobial-free and ventilation-free days
Effect modification by diagnostic certainty and illness severity (subgroup)
- Survival benefit consistent across diagnostic certainty; most pronounced in moderate severity (SOFA 3-9)
- Pre-specified interaction analyses
Original publication
Impact of appropriate antimicrobial therapy on patient outcomes and antimicrobial use: a sub analysis of the DIANA Study Dataset. Intensive Care Med. Published 2 June 2026. doi:10.
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