Impact of empiric antibiotic therapy on outcomes in patients with Pseudomonas aeruginosa bacteremia

Regina B Osih; Jessina C McGregor; Shayna E Rich; Anita C Moore; Jon P Furuno; Eli N Perencevich; Anthony D Harris

doi:10.1128/AAC.00901-06

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Impact of empiric antibiotic therapy on outcomes in patients with Pseudomonas aeruginosa bacteremia

Journal article

Open access

Peer reviewed

Impact of empiric antibiotic therapy on outcomes in patients with Pseudomonas aeruginosa bacteremia

Regina B Osih, Jessina C McGregor, Shayna E Rich, Anita C Moore, Jon P Furuno, Eli N Perencevich and Anthony D Harris

Antimicrobial agents and chemotherapy, Vol.51(3), pp.839-844

03/2007

DOI: 10.1128/AAC.00901-06

PMCID: PMC1803143

PMID: 17194829

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Abstract

The impact of appropriate empirical antimicrobial therapy for Pseudomonas aeruginosa bacteremia on patient outcomes has not been clearly established. We assessed the effect of appropriate empirical therapy on in-hospital mortality and length of stay (LOS) among patients with P. aeruginosa bacteremia. This was a retrospective cohort study of inpatients with a positive blood culture for P. aeruginosa between January 2001 and June 2005. Empirical therapy was defined as appropriate if the patient received an antibiotic the organism was susceptible to between 8 h before culture collection and the time the susceptibility results were available. The severity of the illness was measured 24 h before culture collection. The data were analyzed using logistic regression (in-hospital mortality) and linear regression (LOS). Overall, there were 167 episodes of P. aeruginosa bacteremia, 123 (86%) of which received appropriate empirical antibiotics. Sixty-one patients died (36.5%). The median time from culture collection to susceptibility results was 3.4 days. After we adjusted for age, severity of illness, and time at risk, we found that the appropriate empirical therapy was not significantly associated with mortality (odds ratio = 0.96; 95% confidence interval = 0.31 to 2.93). There was a 7% reduction in the mean LOS for patients who had received appropriate therapy at the time susceptibility results were available compared to those who did not (P = 0.74). These data suggest that the use of appropriate empirical therapy, i.e., before susceptibility results are known may not be as critical to patient outcomes as other studies have suggested.

Length of Stay

Data Interpretation, Statistical

Hospital Mortality

Humans

Middle Aged

Bacteremia - drug therapy

Bacteremia - mortality

Male

Treatment Outcome

Bacteremia - microbiology

Anti-Bacterial Agents - therapeutic use

Regression Analysis

Female

Pseudomonas aeruginosa

Aged

Retrospective Studies

Cohort Studies

Details

Title: Subtitle: Impact of empiric antibiotic therapy on outcomes in patients with Pseudomonas aeruginosa bacteremia
Creators: Regina B Osih - University of Maryland, Department of Epidemiology and Preventive Medicine, 100 N. Greene St. (lower level), Baltimore, MD 21201, USA
Jessina C McGregor
Shayna E Rich
Anita C Moore
Jon P Furuno
Eli N Perencevich
Anthony D Harris
Resource Type: Journal article
Publication Details: Antimicrobial agents and chemotherapy, Vol.51(3), pp.839-844
DOI: 10.1128/AAC.00901-06
PMID: 17194829
PMCID: PMC1803143
NLM abbreviation: Antimicrob Agents Chemother
ISSN: 0066-4804
eISSN: 1098-6596
Publisher: United States
Grant note: K23 AI001752 / NIAID NIH HHS K12 RR023250 / NCRR NIH HHS 1K12 RR 023250-01 / NCRR NIH HHS 1K23 AI 001752-01A1 / NIAID NIH HHS 1R01 AI 60859-01A1 / NIAID NIH HHS
Language: English
Date published: 03/2007
Academic Unit: Epidemiology; Internal Medicine
Record Identifier: 9983779496302771

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