Compliance with antimicrobials de-escalation in septic patients and mortality rates

The International Arabic Journal of Antimicrobial Agents

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Title Compliance with antimicrobials de-escalation in septic patients and mortality rates
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
Description Background
To compare the recent de-escalations rates with a six-year earlier study, and mortality associated with de-escalation.
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.
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).
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
Publisher International Medical Publisher
Date 2019-09-15
Type info:eu-repo/semantics/article
Peer-reviewed Article
Format application/pdf
Source The International Arabic Journal of Antimicrobial Agents; Vol 9 No 3 (2019)
Language eng
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

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