Consequences of inappropriate initial empiric parenteral antibiotic therapy among patients with community-acquired intra-abdominal infections in Spain

To assess the association between inappropriate antibiotic therapy and clinical outcomes for complicated community-acquired intra-abdominal infections in Spain, patient records from October 1998 to August 2002 in 24 hospitals were reviewed. Initial empiric therapy was classified appropriate if all i...

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Bibliographic Details
Published in:	Scandinavian journal of infectious diseases Vol. 39; no. 11-12; pp. 947 - 955
Main Authors:	Tellado, Jose M., Sen, Shuvayu S., Caloto, M. Teresa, Kumar, Ritesh N., Nocea, Gonzalo
Format:	Journal Article
Language:	English
Published:	Basingstoke Informa UK Ltd 2007 Taylor & Francis
Subjects:	Abdomen Adolescent Adult Aged Aged, 80 and over Anti-Bacterial Agents - administration & dosage Anti-Bacterial Agents - therapeutic use Antibacterial agents Antibiotics. Antiinfectious agents. Antiparasitic agents Bacterial Infections - complications Bacterial Infections - drug therapy Biological and medical sciences Community-Acquired Infections - drug therapy Drug Utilization Review Female Humans Male Medical sciences Middle Aged Pharmacology. Drug treatments Spain Treatment Outcome Europe Spain Human Antibiotic Community acquired infection Intravenous administration Antibacterial agent Parenteral administration Abdomen
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Summary:	To assess the association between inappropriate antibiotic therapy and clinical outcomes for complicated community-acquired intra-abdominal infections in Spain, patient records from October 1998 to August 2002 in 24 hospitals were reviewed. Initial empiric therapy was classified appropriate if all isolates were sensitive to at least 1 of the antibiotics administered. Multivariate analyses were performed to assess associations between appropriateness of therapy and patient outcomes. Healthcare resource use was measured as hospital length of stay (LOS) and d on intravenous antibiotic therapy. A total of 425 patients were included. Of these, 387 (91%) received appropriate initial empiric therapy. Patients on inappropriate therapy were less likely to have clinical success (79% vs 26%, p<0.001), more likely to require additional antibiotic therapy (40% vs 7%, p<0.01) and more likely to be re-hospitalized within 30 d of discharge (18% vs 3%, p<0.01). Multivariate analyses also showed that inappropriate therapy was associated with an almost 16% increase in LOS (p<0.05) and 26% in d of intravenous antibiotic therapy compared with appropriate therapy (p<0.05). Inappropriate initial antibiotic therapy was associated with a significantly higher proportion of unsuccessful patient outcomes (including death, re-operation, re-hospitalization or additional parental antibiotic therapies), increased length of stay and length on therapy.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0036-5548 1651-1980
DOI:	10.1080/00365540701449377