Impact of inappropriate initial antibiotics in critically ill surgical patients with bacteremia.
Am J Surg
; 211(3): 593-8, 2016 Mar.
Article
em En
| MEDLINE
| ID: mdl-26778270
ABSTRACT
BACKGROUND:
Bloodstream infections in critically ill patients are associated with mortality as high as 60% and a prolonged hospital stay. We evaluated the impact of inappropriate antibiotic therapy (IAAT) in a critically ill surgical cohort with bacteremia.METHODS:
This retrospective study evaluated adults with intensive care unit admission greater than 72 hours and bacteremia. Two groups were evaluated appropriate antibiotic therapy (AAT) vs IAAT.RESULTS:
In 72 episodes of bacteremia, 57 (79%) AAT and 15 (21%) IAAT, mean age was 54 ± 17 years and APACHE II of 17 ± 8. Time to appropriate antibiotics was longer for IAAT (3 ± 5 IAAT vs 1 ± 1 AAT days, P = .003). IAAT was seen primarily with Acinetobacter spp (33% IAAT vs 9% AAT, P = .01) and Enterococcus faecium (26% IAAT vs 7% AAT, P = .03). If 2 or more bacteremic episodes occurred, Acinetobacter spp. was more likely, 32% vs 2%, P = .001.CONCLUSIONS:
AAT selection is imperative in critically patients with bacteremia to reduce the significant impact of inappropriate selection. Repeated episodes of bacteremia should receive special attention.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Procedimentos Cirúrgicos Operatórios
/
Estado Terminal
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Bacteriemia
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Prescrição Inadequada
/
Antibacterianos
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Am J Surg
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Estados Unidos