Satoshi Yamaga1, Nobuaki Shime2. 1. Department of Emergency and Critical Care Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan. 2. Department of Emergency and Critical Care Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan. Electronic address: nshime@hiroshima-u.ac.jp.
Abstract
BACKGROUND: Empirical antimicrobial treatment for patients presenting with bloodstream infections is considered to affect patients' outcome. METHOD: We conducted a single-center, retrospective study of critically-ill patients hospitalized in the intensive care unit, to examine whether the appropriateness of antimicrobial therapy is associated with mortality from bloodstream infections. The primary study endpoints were the mortality and survival time up to 60 days after the sampling of the blood cultures. RESULTS: We enrolled 62 patients with bloodstream infection, of whom 46 received appropriate and 16 received inappropriate, empirical, antimicrobial therapy. The 60-day mortality of appropriately treated (35%) was significantly lower than that of inappropriately treated (88%) patients (p = .0003), with an adjusted odds ratio of dying = 0.043 (95% confidence interval 0.0047-0.23; p = .0011). Survival time differed significantly between the two groups (p = .0004), with an adjusted hazard ratio = 0.34 (95% confidence interval 0.16-0.70; p = .0043). CONCLUSION: Appropriate antimicrobial therapy administered to critically-ill patients presenting with bloodstream infections was associated with a lower 60-day mortality than inappropriate therapy.
BACKGROUND: Empirical antimicrobial treatment for patients presenting with bloodstream infections is considered to affect patients' outcome. METHOD: We conducted a single-center, retrospective study of critically-illpatients hospitalized in the intensive care unit, to examine whether the appropriateness of antimicrobial therapy is associated with mortality from bloodstream infections. The primary study endpoints were the mortality and survival time up to 60 days after the sampling of the blood cultures. RESULTS: We enrolled 62 patients with bloodstream infection, of whom 46 received appropriate and 16 received inappropriate, empirical, antimicrobial therapy. The 60-day mortality of appropriately treated (35%) was significantly lower than that of inappropriately treated (88%) patients (p = .0003), with an adjusted odds ratio of dying = 0.043 (95% confidence interval 0.0047-0.23; p = .0011). Survival time differed significantly between the two groups (p = .0004), with an adjusted hazard ratio = 0.34 (95% confidence interval 0.16-0.70; p = .0043). CONCLUSION: Appropriate antimicrobial therapy administered to critically-illpatients presenting with bloodstream infections was associated with a lower 60-day mortality than inappropriate therapy.