Compliance with antimicrobials de-escalation in septic patients and mortality rates
The International Arabic Journal of Antimicrobial Agents
View Publication Info| Field | Value | |
| Title |
Compliance with antimicrobials de-escalation in septic patients and mortality rates
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| Creator |
Wadi Al Ramahi M.D, FIDSA, Jamal
Abu Khalaf, Omran Abu Shanab, Lamya Obaidat Pharm, Mohammad Al Hasan, Maha Mhanna, Mohammed Abdulghani, Maha Hashim |
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| Description |
Background To compare the recent de-escalations rates with a six-year earlier study, and mortality associated with de-escalation. Methods Settings A prospective multicenter study including septic patients, all were on broad-spectrum antimicrobials (BSA). Excluded from the study patients on antimicrobial prophylaxis, and patients without a microbiological diagnosis, or bacteria were solely BSA-susceptible. The study team made recommendations for antimicrobials de-escalation to the treating physician(s) must an opportunity loomed. Results 182 patients were available for analysis. De-escalation was achieved in 43 (24%) patients. The clinical diagnoses, comorbidities, commonly used antimicrobials, the microbiological diagnoses were not different between the two groups (patients with and without de-escalation). Logistic regression analysis showed no correlation between bacterial species and de-escalation (Nagelkerke R2 = 0.076). Relapsing sepsis and reinfection were not different (P > 0.05). The in-hospital mortality rates for the de-escalated patients were lower (P = 0.015), not on day 30 (P = 0.354). The length of the ICU stay and ward stay were not different (P >0.05), but more de-escalated patients were discharged home from the ICU (P = 0.034), however, patients without de-escalation were discharged more from the ward (P = 0.002). Conclusion De-escalation rates increased within six years from 6.7% - 24% (P = 0.000), with added benefits of shorter ICU stay and less in-hospital mortality |
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| Publisher |
International Medical Publisher
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| Date |
2019-09-15
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| Type |
info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion Peer-reviewed Article |
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| Format |
application/pdf
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| Identifier |
http://imed.pub/ojs/index.php/IAJAA/article/view/2357
10.3823/836 |
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| Source |
The International Arabic Journal of Antimicrobial Agents; Vol 9 No 3 (2019)
2174-9094 |
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| Language |
eng
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| Relation |
http://imed.pub/ojs/index.php/IAJAA/article/view/2357/2091
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| Rights |
Copyright (c) 2019 Jamal Wadi Al Ramahi M.D, FIDSA, Omran Abu Khalaf, Lamya Abu Shanab, Mohammad Obaidat Pharm, Maha Al Hasan, Mohammed Mhanna, Maha Hashim Abdulghani
http://creativecommons.org/licenses/by/4.0 |
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