Impact of Empiric Antimicrobial Therapy on Outcomes in Patients with Escherichia coli and Klebsiella pneumoniae Bacteremia: A Cohort Study
2008

Impact of Antimicrobial Therapy on Bacteremia Outcomes

Sample size: 416 publication 10 minutes Evidence: moderate

Author Information

Author(s): Thom Kerri A, Schweizer Marin L, Osih Regina B, McGregor Jessina C, Furuno Jon P, Perencevich Eli N, Harris Anthony D

Primary Institution: University of Maryland School of Medicine

Hypothesis

Does appropriate empiric antimicrobial therapy improve outcomes in patients with bacteremia due to Escherichia coli or Klebsiella?

Conclusion

Appropriate empiric antimicrobial therapy for E. coli and Klebsiella bacteremia is not associated with lower in-hospital mortality or shortened post-infection length of stay.

Supporting Evidence

  • 73.3% of patients received appropriate empiric antimicrobial therapy.
  • 17% of patients died before discharge from the hospital.
  • The median post-infection length of stay was 7 days.

Takeaway

The study found that giving the right antibiotics early to patients with certain blood infections didn't help them get better or leave the hospital sooner.

Methodology

Retrospective cohort study comparing in-hospital mortality and post-infection length of stay between patients receiving appropriate and inappropriate empiric antimicrobial therapy.

Potential Biases

Physician choice of empiric therapy may have been influenced by unmeasured factors such as prior infections or individual prescribing patterns.

Limitations

The study is observational, making it impossible to control for all confounding variables, and it did not evaluate post-discharge outcomes.

Participant Demographics

Mean age was 55.3 years; 45.3% were male.

Statistical Information

P-Value

0.04

Confidence Interval

95% CI, 0.60 to 1.78

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/1471-2334-8-116

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