Prospective audit of bacteraemia management in a university hospital ICU using a general strategy of short-course monotherapy

The Journal of Antimicrobial Chemotherapy
Alberto CoronaMervyn Singer

Abstract

As optimal antibiotic therapy for bacteraemia remains unknown, different strategies have evolved. Routine practice in the University College London Hospitals intensive care unit (ICU) is to use short-course (5-6 days) monotherapy, unless specifically indicated (e.g. endocarditis, osteomyelitis). We decided to assess this approach for treating community-, hospital-, and ICU-acquired bacteraemia by monitoring clinical response, relapse rate and patient outcome. Six-month prospective observational study from February to July 2000. Mixed medical-surgical tertiary referral ICU. All 713 patients admitted to the ICU over the study period. In total, 102 bacteraemic episodes occurred in 84 patients. Eight (57%) of 14 community-acquired bacteraemias, 22 (79%) of 28 hospital-acquired bacteraemias, and 48 (80%) of 60 ICU-acquired bacteraemias (in 49 patients) were treated with short-course monotherapy. Compared with previous reported studies, these patients had a low rate (23.8%) of death directly attributable to the bacteraemia and a satisfactory clinical response in 72%. Of six relapses (all Gram-negative), four had received combination therapy for severe deep-seated infections. ICU-acquired multidrug-resistant Gram-negative bacteraemias...Continue Reading

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Citations

May 28, 2013·International Journal of Antimicrobial Agents·Ethan Rubinstein, Yoav Keynan
Mar 26, 2010·The Journal of Antimicrobial Chemotherapy·Alberto CoronaMervyn Singer
Mar 16, 2011·The Journal of Antimicrobial Chemotherapy·John R ProwleMervyn Singer
Feb 28, 2014·The Journal of Antimicrobial Chemotherapy·Jonathan D EdgeworthCatherine A McKenzie
Feb 10, 2007·Enfermedades infecciosas y microbiología clínica·José Miguel Cisneros-HerrerosMiguel Salavert-Lletí
Sep 11, 2007·International Journal of Antimicrobial Agents·Ethan Rubinstein
Jul 2, 2015·Einstein·Camila Delfino Ribeiro da Silva, Moacyr Silva Júnior
Mar 11, 2017·Médecine et maladies infectieuses·C WintenbergerUNKNOWN Recommendation Group of the SPILF
Dec 1, 2017·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Darunee ChotiprasitsakulUNKNOWN Antibacterial Resistance Leadership Group
Aug 14, 2018·Journal of Pharmacy Practice·Erik W SkoglundKady Phe
Nov 23, 2017·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Charlotte AilletPierre-Marie Roger
Apr 18, 2020·Critical Care Medicine·Pedro Povoa, Andre C Kalil
May 22, 2018·Open Forum Infectious Diseases·Jesse D SuttonEmily S Spivak
Apr 11, 2018·Military Medicine·Avi BenovAvi Yitzhak

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