Predictors for delayed antibiotic administration among bacteraemic patients in the Emergency Department: Differences between medical and surgical interns.
Eur J Clin Invest
; 50(11): e13324, 2020 Nov.
Article
in En
| MEDLINE
| ID: mdl-32564358
ABSTRACT
BACKGROUND:
Bloodstream infections (BSIs) have been associated with high mortality. The aim of the study was to identify predictors of early (within 3 hours from triage) administration of first antibiotic dose among patients evaluated in the Emergency Department (ED) with BSI and their role in mortality. MATERIALS ANDMETHODS:
All adult patients with BSI at the ED of the Hospital of Jura, Switzerland during a 3 year period (July 2014 to June 2017) were included.RESULTS:
Among 364 BSI, the most common sites of infection were urinary tract (39.6% of BSIs), lower respiratory tract (15.4%), intra-abdominal (15.4%) and primary BSI (9.1%). One-hundred-seventy-eight patients (48.9%) received the first antibiotic dose within 3 hours from triage. Multivariate analysis identified evaluation by internal medicine intern, triage scales 1 and 2, as predictors of early antibiotic administration, while, primary BSI was associated with delayed antibiotic administration. Thirty-day mortality was 12.9% (47 patients). Charlson comorbidity index, septic shock, low respiratory tract infection were independently associated with mortality, while antibiotic administration within 3 hours from triage and source control within 48 hours from triage were associated with survival.CONCLUSIONS:
The majority of patients received the first antibiotic dose after 3 hours Patients evaluated by surgical interns had a significant delay in administration of antibiotics as compared to those treated by medical interns.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Mortality
/
Bacteremia
/
Sepsis
/
Emergency Service, Hospital
/
Time-to-Treatment
/
Internship and Residency
/
Anti-Bacterial Agents
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
Eur J Clin Invest
Year:
2020
Document type:
Article
Affiliation country:
Switzerland