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.