Abstract
To investigate the clinical outcomes of patients with septic shock related to community-onset monomicrobial Enterobacteriaceae (CoME) bacteremia as categorized by the strategy of antimicrobial therapy, a retrospective and observational study was conducted. Clinical information on the patients was obtained from medical records. Antibiotic regimens were ranked according to their activity spectrum against Enterobacteriaceae (category IV, highest; I, lowest). De-escalation was defined as a switch to a category with a narrower spectrum of coverage within 5. days after the bacteremic onset. Of the 189 eligible patients, 86 (45.5%) patients received de-escalation antibiotic therapy, and most (48, 55.8%) of the patients were empirically treated first with a category IV antibiotic. In a multivariate analysis for 28-day mortality, of several independent predictors, the de-escalation strategy was protective (odds ratio, 0.37; P=. 0.04). In conclusion, for patients with CoME bacteremia and available susceptibility data, de-escalation of antimicrobial therapy was beneficial for improving clinical outcome.
| Original language | English |
|---|---|
| Pages (from-to) | 158-164 |
| Number of pages | 7 |
| Journal | Diagnostic Microbiology and Infectious Disease |
| Volume | 82 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2015 Jun 1 |
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All Science Journal Classification (ASJC) codes
- Microbiology (medical)
- Infectious Diseases
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Impact of antimicrobial strategies on clinical outcomes of adults with septic shock and community-onset Enterobacteriaceae bacteremia : De-escalation is beneficial. / Lee, Ching Chi; Lee, Nan-Yao; Chen, Po-Lin; Hong, Ming-Yuan; Chan, Tsung-Yu; Chi, Chih-Hsien; Ko, Wen-Chien.
In: Diagnostic Microbiology and Infectious Disease, Vol. 82, No. 2, 01.06.2015, p. 158-164.Research output: Contribution to journal › Article
TY - JOUR
T1 - Impact of antimicrobial strategies on clinical outcomes of adults with septic shock and community-onset Enterobacteriaceae bacteremia
T2 - De-escalation is beneficial
AU - Lee, Ching Chi
AU - Lee, Nan-Yao
AU - Chen, Po-Lin
AU - Hong, Ming-Yuan
AU - Chan, Tsung-Yu
AU - Chi, Chih-Hsien
AU - Ko, Wen-Chien
PY - 2015/6/1
Y1 - 2015/6/1
N2 - To investigate the clinical outcomes of patients with septic shock related to community-onset monomicrobial Enterobacteriaceae (CoME) bacteremia as categorized by the strategy of antimicrobial therapy, a retrospective and observational study was conducted. Clinical information on the patients was obtained from medical records. Antibiotic regimens were ranked according to their activity spectrum against Enterobacteriaceae (category IV, highest; I, lowest). De-escalation was defined as a switch to a category with a narrower spectrum of coverage within 5. days after the bacteremic onset. Of the 189 eligible patients, 86 (45.5%) patients received de-escalation antibiotic therapy, and most (48, 55.8%) of the patients were empirically treated first with a category IV antibiotic. In a multivariate analysis for 28-day mortality, of several independent predictors, the de-escalation strategy was protective (odds ratio, 0.37; P=. 0.04). In conclusion, for patients with CoME bacteremia and available susceptibility data, de-escalation of antimicrobial therapy was beneficial for improving clinical outcome.
AB - To investigate the clinical outcomes of patients with septic shock related to community-onset monomicrobial Enterobacteriaceae (CoME) bacteremia as categorized by the strategy of antimicrobial therapy, a retrospective and observational study was conducted. Clinical information on the patients was obtained from medical records. Antibiotic regimens were ranked according to their activity spectrum against Enterobacteriaceae (category IV, highest; I, lowest). De-escalation was defined as a switch to a category with a narrower spectrum of coverage within 5. days after the bacteremic onset. Of the 189 eligible patients, 86 (45.5%) patients received de-escalation antibiotic therapy, and most (48, 55.8%) of the patients were empirically treated first with a category IV antibiotic. In a multivariate analysis for 28-day mortality, of several independent predictors, the de-escalation strategy was protective (odds ratio, 0.37; P=. 0.04). In conclusion, for patients with CoME bacteremia and available susceptibility data, de-escalation of antimicrobial therapy was beneficial for improving clinical outcome.
UR - http://www.scopus.com/inward/record.url?scp=84929050473&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84929050473&partnerID=8YFLogxK
U2 - 10.1016/j.diagmicrobio.2015.03.004
DO - 10.1016/j.diagmicrobio.2015.03.004
M3 - Article
C2 - 25796557
AN - SCOPUS:84929050473
VL - 82
SP - 158
EP - 164
JO - Diagnostic Microbiology and Infectious Disease
JF - Diagnostic Microbiology and Infectious Disease
SN - 0732-8893
IS - 2
ER -