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Volume 37, Issue 3

Original Article

Impact of Early Initiation of Appropriate Antibiotic Therapy on Outcome of Bloodstream Infections

Saliha Kazcı
Affiliations
  • Ankara Bilkent Şehir Hastanesi, Tıbbi Mikrobiyoloji Kliniği, Ankara, Türkiye
https://orcid.org/0000-0002-8937-9939
,
Halime Araz
Affiliations
  • Ankara Bilkent Şehir Hastanesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Kliniği, Ankara, Türkiye
https://orcid.org/0000-0003-4774-5950
,
İpek Mumcuoğlu
Affiliations
  • Dr. Abdurrahman Yurtaslan Ankara Onkoloji Eğitim ve Araştırma Hastanesi, Tıbbi Mikrobiyoloji Kliniği, Ankara, Türkiye
https://orcid.org/0000-0002-6392-8880
,
Başak Dokuzoğuz
Affiliations
  • Ankara Bilkent Şehir Hastanesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Kliniği, Ankara, Türkiye
https://orcid.org/0000-0001-7403-3292
  • appropriate empiric antibiotic treatment
  • bloodstream infection
  • mortality

Abstract

Objective: Bloodstream infections (BSIs) remain a leading cause of morbidity and mortality. We aimed to evaluate the appropriateness of empiric antimicrobial treatment in patients with BSI and its effect on mortality and hospital stay.

Methods: 100 BSI-diagnosed patients aged 18 and older were included in the study. Sociodemographic characteristics, clinical and microbiological data, empirically initiated treatments, time to appropriate treatment, 10th-day (early period) and hospital discharge mortality rates, and lengths of hospital stay were recorded. Data were analyzed using Pearson χ², Fisher’s exact test, trend χ² test, and Mann-Whitney U test. Logistic regression assessed the impact on mortality, with p <0.05 considered statistically significant.

Results: 51% of cases were female, and the median age was 64 (min-max=19-94). No significant difference was found between appropriate and inappropriate antibiotic treatment groups in age, sex, clinical severity, Charlson comorbidity index (CCI) scores, and microorganism distribution. However, multidrug-resistant organisms were significantly more common in the inappropriate empiric treatment group (p=0.001). Of all BSIs, 57% were hospital-acquired, and 43% were community-onset, with primary BSIs accounting for 55%. No significant difference was found between the groups in terms of where BSI was acquired and its source. Empiric treatment appropriateness was 57%, with resistance among microorganisms being the main factor in inappropriate treatment. Early period (10th-day) mortality was 26%, and hospital discharge mortality was 41%, with no significant association found between the empiric treatment, appropriateness, time to appropriate treatment, and mortality. However, inappropriate empiric treatment was significantly associated with higher hospital discharge mortality (p=0.033) in immunocompetent patients. Hospital stay was significantly shorter in the appropriate empiric treatment group compared to the inappropriate group (p=0.035).

Conclusion: We did not find significant impact of the appropriateness of antimicrobial treatment and time to appropriate treatment on mortality but appropriate treatment significantly shortened hospital stays.

  • 187-95
  • Saliha Kazcı
  • [email protected]
  • 10.36519/kd.2024.4958
  • March 3, 2024
  • August 2, 2024
  • September 27, 2024

  • Kazcı S, Araz H, Mumcuoğlu İ, Dokuzoğuz B. [Impact of early initiation of appropriate antibiotic therapy on outcome of bloodstream infections]. Klimik Derg. 2024;37(3):187-95. Turkish.
  • 220
  • 63
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  • This work is licensed under a Creative Commons Attribution-Non Commercial 4.0 International License. CC BY-NC
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