Microbiological outcomes and antibiotic overuse in Emergency Department patients with suspected sepsis.
Neth J Med
; 75(5): 196-203, 2017 Jun.
Article
en En
| MEDLINE
| ID: mdl-28653945
ABSTRACT
OBJECTIVE:
To study the presence of bacterial disease and antibiotic use in patients in the emergency department (ED) included in the local sepsis protocol.METHODS:
An observational retrospective cohort study. Adults aged > 18 years, presenting to the ED of a large teaching hospital, from 1 January to 1 June 2011, with more than two SIRS criteria and a clinical suspicion of sepsis were included.RESULTS:
Bacterial disease was suspected or confirmed in only 71% of all the patients with suspected sepsis (2008 definition) and consequently treated with antibiotics. Most of these patients (58%) suffered from systemic inflammatory response syndrome (SIRS) without signs of organ dysfunction, hypotension or hypoperfusion. Despite absence of bacterial disease in 29% of the patients after rigorous diagnostics, median antibiotic treatment in this group was still seven days (IQR 4-10).CONCLUSIONS:
Standard sepsis detection using SIRS criteria and clinical suspicion identified patients with suspected or confirmed bacterial disease in 71% of the cases. A significant proportion of patients were exposed to prolonged antibiotic use without proof of bacterial disease. This study illustrates the difficulties in correctly identifying bacterial disease and sepsis, and shows that overuse of antibiotics may be the consequence.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Infecciones Bacterianas
/
Sepsis
/
Servicio de Urgencia en Hospital
/
Uso Excesivo de Medicamentos Recetados
/
Antibacterianos
Tipo de estudio:
Guideline
/
Observational_studies
/
Prognostic_studies
Límite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Neth J Med
Año:
2017
Tipo del documento:
Article
País de afiliación:
Países Bajos