Duration of antibiotic treatment in surgical infections of the abdomen. Minimal antibiotic therapy: technology assessment instead of clinical trials.
In modern medicine which already uses maximal resources, additional improvements involve huge extra efforts. With increasing complexity of diseases, specific treatments have only a limited influence on the "whole process". In complex clinical situations (including sepsis and SIRS) the available methodology to identify groups of patients who may benefit from a specific treatment are weak. This is why prospective randomised "megatrials" may be needed to detect small differences in outcome. We suggest that careful prospective assessment of cohorts of well stratified patients, subjected to a specific and standardised treatment, may replace prospective controlled trials.
Fire Department Cologne, Center for Emergency Medicine, Köln, Germany.
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Lechleuthner
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Troidl
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Lefering
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002985:Clinical Protocols; D002986:Clinical Trials as Topic; D006801:Humans; D011446:Prospective Studies; D012107:Research Design; D013673:Technology Assessment, Biomedical
D000900:Anti-Bacterial Agents