Please use this identifier to cite or link to this item: http://hdl.handle.net/10668/2001
Título : Impact of inadequate empirical therapy on the mortality of patients with bloodstream infections: a propensity score-based analysis.
Autor : Retamar, Pilar
Portillo, María M
López-Prieto, María Dolores
Rodríguez-López, Fernando
Cueto, Marina de
García, María V
Gómez, María J
Arco, Alfonso Del
Muñoz, Angel
Sánchez-Porto, Antonio
Torres-Tortosa, Manuel
Martín-Aspas, Andrés
Arroyo, Ascensión
García-Figueras, Carolina
Acosta, Federico
Corzo, Juan E
León-Ruiz, Laura
Escobar-Lara, Trinidad
Rodríguez-Baño, Jesús
Filiación: [Retamar,P; Portillo,MM;Cueto,M de; Rodríguez-Baño,J] Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Seville, Spain. [López-Prieto,MD; García-Figueras,C] Unidad Clínica de Microbiología y Enfermedades Infecciosas, Hospital del SAS, Jerez de la Frontera, Cádiz, Spain. [Rodríguez-López,F] Servicio de Microbiología, Hospital Universitario Reina Sofía, Córdoba, Spain. [García,MV] Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen de la Victoria, Málaga, Spain. [Gómez,MJ] Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío, Seville, Spain. [Arco,A Del] Unidades de Enfermedades Infecciosas, Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, Spain. [Muñoz,A] Servicio de Medicina Interna, Hospital de la Serranía, Ronda, Málaga, Spain. [Sánchez-Porto,A] Unidad de Microbiología, Hospital de La Línea, Cádiz, Spain. [Torres-Tortosa,M] Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Punta de Europa, Algeciras, Cádiz, Spain. [Martín-Aspas,A] Servicio de Medicina Interna, Hospital Puerta del Mar, Cádiz, Spain. [Arroyo,A] Sección de Enfermedades Infecciosas, Complejo Hospitalario de Jaén, Jaén, Spain. [Acosta,F] Servicio de Medicina Interna, Hospital de Antequera, Málaga, Spain. [Corzo,JE] Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Seville, Spain. [León-Ruiz,L] Sección de Enfermedades Infecciosas, Hospital Torrecárdenas, Almería, Spain. [Escobar-Lara,T] Servicio de Microbiología, Hospital Universitario San Cecilio, Granada, Spain. [Rodríguez-Baño,J] Department of Medicine, University of Seville, Seville, Spain.
Grupo de Investigación: SAEI/SAMPAC Bacteremia Group
Palabras clave : Antibacterianos
Agranulocitosis
Bacteriemia
Farmacorresistencia bacteriana
Errores médicos
Pruebas de sensibilidad microbiana
MeSH: Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Bacteremia
Medical Subject Headings::Phenomena and Processes::Microbiological Phenomena::Bacterial Physiological Phenomena::Drug Resistance, Bacterial
Medical Subject Headings::Check Tags::Female
Medical Subject Headings::Organisms::Bacteria::Gram-Negative Bacteria
Medical Subject Headings::Organisms::Bacteria::Gram-Positive Bacteria
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Logistic Models
Medical Subject Headings::Check Tags::Male
Medical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Services::Medical Errors
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Microbiological Techniques::Microbial Sensitivity Tests
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle Aged
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Propensity Score
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors
Medical Subject Headings::Geographicals::Geographic Locations::Europe::Spain
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality::Survival Rate
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Aged
Fecha de publicación : Jan-2012
Editorial : American Society for Microbiology
Cita Bibliográfica: Retamar P, Portillo MM, López-Prieto MD, Rodríguez-López F, Cueto M de, García MV, et al. Impact of inadequate empirical therapy on the mortality of patients with bloodstream infections: a propensity score-based analysis. Antimicrob. Agents Chemother. 2012; 56(1):472-8
Abstract: The impact of the adequacy of empirical therapy on outcome for patients with bloodstream infections (BSI) is key for determining whether adequate empirical coverage should be prioritized over other, more conservative approaches. Recent systematic reviews outlined the need for new studies in the field, using improved methodologies. We assessed the impact of inadequate empirical treatment on the mortality of patients with BSI in the present-day context, incorporating recent methodological recommendations. A prospective multicenter cohort including all BSI episodes in adult patients was performed in 15 hospitals in Andalucía, Spain, over a 2-month period in 2006 to 2007. The main outcome variables were 14- and 30-day mortality. Adjusted analyses were performed by multivariate analysis and propensity score-based matching. Eight hundred one episodes were included. Inadequate empirical therapy was administered in 199 (24.8%) episodes; mortality at days 14 and 30 was 18.55% and 22.6%, respectively. After controlling for age, Charlson index, Pitt score, neutropenia, source, etiology, and presentation with severe sepsis or shock, inadequate empirical treatment was associated with increased mortality at days 14 and 30 (odds ratios [ORs], 2.12 and 1.56; 95% confidence intervals [95% CI], 1.34 to 3.34 and 1.01 to 2.40, respectively). The adjusted ORs after a propensity score-based matched analysis were 3.03 and 1.70 (95% CI, 1.60 to 5.74 and 0.98 to 2.98, respectively). In conclusion, inadequate empirical therapy is independently associated with increased mortality in patients with BSI. Programs to improve the quality of empirical therapy in patients with suspicion of BSI and optimization of definitive therapy should be implemented.
Descripción : Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't;
URI: http://hdl.handle.net/10668/2001
Versión del editor : http://aac.asm.org/content/56/1/472.abstract
DOI: 10.1128/AAC.00462-11
ISSN : 1098-6596 (Online)
0066-4804 (Print)
Appears in Collections:01- Artículos - Hospital Puerta del Mar
01- Artículos - Hospital San Cecilio
01- Artículos - Complejo Hospitalario Torrecárdenas
01- Artículos - Hospital de Valme
01- Artículos - AGS Norte de Málaga
01- Artículos - Complejo Hospitalario de Jaén
01- Artículos - AGS Campo de Gibraltar
01- Artículos - AGS Serranía de Málaga
01- Artículos - Hospital Reina Sofía
01- Artículos - Hospital Virgen del Rocío
01- Artículos - Hospital Virgen de la Victoria
01- Artículos - APES Costa del Sol
01- Artículos - Hospital de Jerez
01- Artículos - Hospital Virgen Macarena

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