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Antimicrobial agent prescription: a prospective cohort study in patients with sepsis and septic shock
Author(s) -
Castaño Pablo,
Plaza Maribel,
Molina Fernando,
Hincapié Carolina,
Maya Wilmar,
Cataño Juan,
González Javier,
León Alba,
Jaimes Fabián
Publication year - 2019
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.13186
Subject(s) - medicine , medical prescription , antibiotics , prospective cohort study , septic shock , logistic regression , sepsis , cohort , cohort study , intensive care medicine , pharmacology , microbiology and biotechnology , biology
Abstract Objective To assess the true association between appropriate prescription of antibiotics and prognosis in patients with sepsis, a key issue in health care and quality improvement strategies. Methods Prospective cohort study in three university hospitals to determine whether the empirical prescription of antibiotics was adequate or inadequate, and to compare hospital death rates and length of stay according to different classifications of antibiotics prescription. Logistic regression models for risk estimation were fitted. Results A total of 705 patients with severe sepsis were included. No differences were found in positive‐culture patients ( n = 545) regarding the risk of death with insufficient spectrum antibiotics, compared to patients who received adequate spectrum antibiotics ( OR = 0.90; 95% CI = 0.55–1.48). Delay in initiating antibiotics was not associated with the risk of death in patients with adequate spectrum of antibiotics, either with positive ( OR = 1.04; 95% CI = 0.99–1.08) or negative cultures ( OR = 0.98; 95% CI = 0.92–1.04). There were no differences in the length of hospital stay, according to the antibiotic prescription (median 11 days, IQR = 7–18 days for the whole cohort). Conclusions No associations were found between inadequate antibiotic prescription or delay to initiate therapy and mortality or length of stay.