التفاصيل البيبلوغرافية
| العنوان: |
Appropriateness of empiric antimicrobial therapy with imipenem/colistin in severe septic patients: observational cohort study. |
| المؤلفون: |
Trifi, Ahlem, Abdellatif, Sami, Abdennebi, Cyrine, Daly, Foued, Nasri, Rochdi, Touil, Yosr, Ben Lakhal, Salah |
| المصدر: |
Annals of Clinical Microbiology & Antimicrobials; 11/16/2018, Vol. 17 Issue 1, p1-11, 11p |
| مصطلحات موضوعية: |
SEPTICEMIA treatment, ANTI-infective agents, IMIPENEM, COLISTIN, COHORT analysis |
| مستخلص: |
Background: Empiric antimicrobial therapy (EAMT) using imipenem/colistin is commonly prescribed as a first line therapy in critically ill patients with severe sepsis. We aimed to assess the appropriateness of prescribing imipenem/colistin as EAMT in ICU patients. Methods: A 3-year observational prospective study included ICU patients that required imipenem/colistin as EAMT. The EAMT was assessed according to microbiological and clinical outcomes. The outcomes were: delay in apyrexia, delay in the decrease of the biological inflammatory parameters (BIP), the requirement for vasoactive agents, bacteriological eradication, length of stay, ventilator days and 30-day mortality. Results: 79 administrations of EAMT in 70 patients were studied. EAMT was appropriate in 52% of the studied cases. An ICU stay > 6 days was related to inappropriateness, and chronic respiratory failure was associated with appropriateness. In the appropriate EAMT group, we showed: earlier apyrexia, shorter delay in the decrease of the BIP and a reduced significant vasopressors requirement. Furthermore, EAMT improved survival with a median gain of 4 days. Inappropriate EAMT increased the mortality risk by six. The acquisition of NI in ICU was also an independent factor of mortality. Conclusions: EAMT using imipenem-colistin was appropriate in half of the cases and inappropriateness was associated with an increased ICU mortality risk. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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