Empiric Antibiotic Therapy for Severe Sepsis and Septic Shock.
Surg Infect (Larchmt)
; 17(2): 210-6, 2016 Apr.
Article
em En
| MEDLINE
| ID: mdl-26630548
ABSTRACT
BACKGROUND:
A retrospective study was conducted to investigate the validity and the effectiveness of early empiric antibiotic and de-escalation therapy for the treatment of severe sepsis and septic shock patients in the intensive care unit (ICU).METHODS:
Patients admitted to the ICU at Chiba University Hospital from January 1, 2010, to December 31, 2012, for the treatment of severe sepsis or septic shock were selected for analysis.RESULTS:
One-hundred and ten patients were enrolled for the analysis. Carbapenems were selected most frequently (57.3%), followed by cephalosporins (22.7%), and penicillins (21.8%). Empiric antibiotic therapy was appropriate for 85 (77.3%) patients. Mortality rates for patients with inappropriate empiric therapy was 36.8%, whereas mortality rates for patients with appropriate empiric therapy was 17.5%. Among the patients with appropriate empiric antibiotic administration, de-escalation was associated with lower mortality rates of 5.0% for severe sepsis and 9.7% for septic shock patients. The mortality rates for the no de-escalation group were 19.0% and 35.7%, respectively.CONCLUSION:
Empiric antibiotic therapy was acceptable for severe sepsis and septic shock patients treated in the ICU. The appropriate selection of empiric antibiotics was related to a greater rate of de-escalation and better survival. The risk of multi-drug-resistant bacterial infections was not as high as expected, but will need further attention in the future.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Sepse
/
Prevenção Secundária
/
Antibacterianos
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
Surg Infect (Larchmt)
Assunto da revista:
BACTERIOLOGIA
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Japão