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 5days 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.
References
Sep 1, 1991·Archives of Internal Medicine·L LeiboviciA J Wysenbeek
Feb 1, 1991·Diabetes Care·L LeiboviciM Drucker
Mar 27, 1995·Archives of Internal Medicine·D W BatesT H Lee
Aug 1, 1994·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·J B HaugC O Solberg
May 1, 1993·Journal of Clinical Epidemiology·F G SchellevisC van Weel
Dec 10, 1998·Journal of Internal Medicine·L LeiboviciS D Pitlik
Mar 20, 1999·Chest·R R Yates
Jul 14, 2000·Chest·E H IbrahimM H Kollef
Apr 9, 2001·Critical Care Medicine·M S Niederman
Feb 11, 2003·Critical Care Medicine·Marc LeoneClaude Martin
Nov 6, 2003·The American Journal of Medicine·Stephan HarbarthDidier Pittet
May 11, 2006·Chest·Marin H KollefFrank J Rodino
Dec 26, 2007·Critical Care Medicine·R Phillip DellingerUNKNOWN World Federation of Societies of Intensive and Critical Care Medicine
Aug 12, 2008·The American Journal of Medicine·Hae Suk CheongKyong Ran Peck
Dec 30, 2011·The American Journal of Emergency Medicine·Ching-Chi LeeWen-Chien Ko
Mar 21, 2012·Critical Care Medicine·Sarah HeenenJean-Louis Vincent
Dec 25, 2012·The Journal of Antimicrobial Chemotherapy·Hang-Cheng ChenChien-Chang Lee
Citations
Mar 24, 2016·International Journal of Antimicrobial Agents·Chih-Chia HsiehChing-Chi Lee
Jul 2, 2016·The Canadian Journal of Infectious Diseases & Medical Microbiology = Journal Canadien Des Maladies Infectieuses Et De La Microbiologie Médicale·Peter DaleyCarla Penney
Jun 25, 2016·Heart & Lung : the Journal of Critical Care·Ying GuoShujian Sui
Aug 7, 2016·Critical Care Research and Practice·Nawal SalahuddinKhalid Maghrabi
Oct 25, 2016·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·M PaulA Raz-Pasteur
Aug 20, 2016·Infection·J KatchanovAchim J Kaasch
Nov 12, 2016·International Journal of Antimicrobial Agents·Chih-Chia HsiehChing-Chi Lee
Jun 29, 2017·Medicine·Tsung-Hang KuoChing-Chi Lee
Aug 25, 2017·Expert Review of Clinical Pharmacology·José Garnacho-MonteroMarin H Kollef
Sep 20, 2017·Antimicrobial Agents and Chemotherapy·Ching-Chi LeeWen-Chien Ko
Nov 18, 2016·Antimicrobial Agents and Chemotherapy·Ching-Chi LeeWen-Chien Ko
Dec 21, 2018·Expert Review of Anti-infective Therapy·Calypso MathieuMarc Leone
Mar 18, 2020·Expert Review of Anti-infective Therapy·Inger Van HeijlCornelis H Van Werkhoven
May 27, 2017·Critical Care : the Official Journal of the Critical Care Forum·Ching-Chi LeeWen-Chien Ko
Nov 12, 2016·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·M J BruinsM J H M Wolfhagen
Dec 29, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Xiuwen WuJianan Ren
Feb 13, 2021·Médecine et maladies infectieuses·S DiamantisR Gauzit
Oct 3, 2019·Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy·Chao-Yung YangChing-Chi Lee
Aug 27, 2021·Journal of Intensive Care·Moritoki EgiOsamu Nishida