Juan González-Del Castillo1, Clara Domínguez-Bernal2, María Cristina Gutiérrez-Martín2, María José Núñez-Orantos3, Francisco Javier Candel4, Francisco Javier Martín-Sánchez5. 1. Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, España; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, España. Electronic address: jgonzalezcast@gmail.com. 2. Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, España. 3. Servicio de Medicina Interna, Hospital Clínico San Carlos, Madrid, España. 4. Servicio de Microbiología Clínica, Hospital Clínico San Carlos, Madrid, España. 5. Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, España; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, España.
Abstract
INTRODUCTION: The main objective of the study was to determine the frequency of patients receiving inappropriate empiric antibiotic therapy and to assess the impact in terms of increase length of hospital stay, 30-day re-admissions, and 30-day mortality. METHODS: An observational retrospective cohort study was conducted over a one-month period that included all patients hospitalised from an Emergency Department (ED) due to infection. Demographic variables, comorbidity, multi-resistance risk factors, site of infection, microbiological findings, and antibiotic prescribed in ED were collected. Outcomes were length of hospital stay, 30-day re-admissions, and 30-day mortality. RESULTS: A total of 376 patients were included, with a mean age of 71.1 (SD 21) years. The most frequent causes were respiratory (45.7%) and urine (23.9%) infections. The number of patients with length of stay over the median (≥9 days) was 165 (46.1%), with re-admissions 74 (19.7%), and mortality at 30 days 44 (11.7%). There was inappropriate antibiotic treatment in 42 (11.2%) cases. After adjusting for demographic data, comorbidity, risk factors for multidrug resistant organism, presence of sepsis criteria in ED, and site of infection, inappropriate treatment was associated with an extended length of hospital stay (OR 2.22; 95% CI; 1.07-4.60; P=.032), but did not to an increase in mortality (P=.271) or re-admission (P=.784) at 30 days. CONCLUSION: The inappropriate empirical antibiotic therapy in patients admitted from the ED leads to an extended hospital stay, but did not increase mortality or readmission.
INTRODUCTION: The main objective of the study was to determine the frequency of patients receiving inappropriate empiric antibiotic therapy and to assess the impact in terms of increase length of hospital stay, 30-day re-admissions, and 30-day mortality. METHODS: An observational retrospective cohort study was conducted over a one-month period that included all patients hospitalised from an Emergency Department (ED) due to infection. Demographic variables, comorbidity, multi-resistance risk factors, site of infection, microbiological findings, and antibiotic prescribed in ED were collected. Outcomes were length of hospital stay, 30-day re-admissions, and 30-day mortality. RESULTS: A total of 376 patients were included, with a mean age of 71.1 (SD 21) years. The most frequent causes were respiratory (45.7%) and urine (23.9%) infections. The number of patients with length of stay over the median (≥9 days) was 165 (46.1%), with re-admissions 74 (19.7%), and mortality at 30 days 44 (11.7%). There was inappropriate antibiotic treatment in 42 (11.2%) cases. After adjusting for demographic data, comorbidity, risk factors for multidrug resistant organism, presence of sepsis criteria in ED, and site of infection, inappropriate treatment was associated with an extended length of hospital stay (OR 2.22; 95% CI; 1.07-4.60; P=.032), but did not to an increase in mortality (P=.271) or re-admission (P=.784) at 30 days. CONCLUSION: The inappropriate empirical antibiotic therapy in patients admitted from the ED leads to an extended hospital stay, but did not increase mortality or readmission.
Authors: J Villanueva; L Montes-Andujar; O V Baez-Pravia; E J García-Lamberechts; J González Del Castillo; A Ruiz; C Zurdo; J Barberán; J Menéndez; P Cardinal-Fernández Journal: Rev Esp Quimioter Date: 2020-08-05 Impact factor: 1.553
Authors: Olalla Vazquez-Cancela; Laura Souto-Lopez; Juan M Vazquez-Lago; Ana Lopez; Adolfo Figueiras Journal: PLoS One Date: 2021-02-04 Impact factor: 3.240