Long-term adherence to a 5 day antibiotic course guideline for treatment of intensive care unit (ICU)-associated Gram-negative infections
Long-term adherence to a 5 day antibiotic course guideline for treatment of intensive care unit (ICU)-associated Gram-negative infections
Objectives
To determine long-term adherence to a 5 day antibiotic course guideline for treating intensive care unit (ICU)-acquired Gram-negative bacteria (GNB) infections.
Methods
Descriptive analysis of patient-level data on all GNB-active antibiotics prescribed from day 3 and all GNB identified in clinical samples in 5350 patients admitted to a 30 bed general ICU between 2002 and 2009.
Results
Four thousand five hundred and eleven of 5350 (84%) patients were treated with one or more antibiotics active against GNB commenced from day 3. Gentamicin was the most frequently prescribed antibiotic (92.2 days of therapy/1000 patient-days). Only 6% of courses spanned >6 days of therapy and 89% of antibiotic therapy days were with a single antibiotic active against GNB. There was no significant difference between gentamicin and meropenem in the number of first courses in which a resistant GNB was identified in blood cultures [11/1177 (0.9%) versus 5/351 (1.4%); P = 0.43] or respiratory tract specimens [59/951 (6.2%) versus 17/246 (6.9%); P = 0.68] at the time of starting therapy.
Conclusions
This study demonstrates long-term adherence to a 5 day course antibiotic guideline for treatment of ICU-associated GNB infections. This guideline is a potential antibiotic-sparing alternative to currently recommended dual empirical courses extending to ≥7 days.
1688-1694
Edgeworth, J.D.
354fe3b0-cb55-4589-be84-932dc2a94223
Ster, I.C.
8c6477db-242c-49c6-805e-c763362f9429
Wyncoll, D.
17052831-9b87-4cd8-ac3e-941ef916473c
Shankar-Hari, M.
6168fb5a-39fd-4713-a885-e7479d6b6775
McKenzie, C.A.
ec344dee-5777-49c5-970e-6326e82c9f8c
2014
Edgeworth, J.D.
354fe3b0-cb55-4589-be84-932dc2a94223
Ster, I.C.
8c6477db-242c-49c6-805e-c763362f9429
Wyncoll, D.
17052831-9b87-4cd8-ac3e-941ef916473c
Shankar-Hari, M.
6168fb5a-39fd-4713-a885-e7479d6b6775
McKenzie, C.A.
ec344dee-5777-49c5-970e-6326e82c9f8c
Edgeworth, J.D., Ster, I.C., Wyncoll, D., Shankar-Hari, M. and McKenzie, C.A.
(2014)
Long-term adherence to a 5 day antibiotic course guideline for treatment of intensive care unit (ICU)-associated Gram-negative infections.
Journal of Antimicrobial Chemotherapy, 69 (6), .
(doi:10.1093/jac/dku038).
Abstract
Objectives
To determine long-term adherence to a 5 day antibiotic course guideline for treating intensive care unit (ICU)-acquired Gram-negative bacteria (GNB) infections.
Methods
Descriptive analysis of patient-level data on all GNB-active antibiotics prescribed from day 3 and all GNB identified in clinical samples in 5350 patients admitted to a 30 bed general ICU between 2002 and 2009.
Results
Four thousand five hundred and eleven of 5350 (84%) patients were treated with one or more antibiotics active against GNB commenced from day 3. Gentamicin was the most frequently prescribed antibiotic (92.2 days of therapy/1000 patient-days). Only 6% of courses spanned >6 days of therapy and 89% of antibiotic therapy days were with a single antibiotic active against GNB. There was no significant difference between gentamicin and meropenem in the number of first courses in which a resistant GNB was identified in blood cultures [11/1177 (0.9%) versus 5/351 (1.4%); P = 0.43] or respiratory tract specimens [59/951 (6.2%) versus 17/246 (6.9%); P = 0.68] at the time of starting therapy.
Conclusions
This study demonstrates long-term adherence to a 5 day course antibiotic guideline for treatment of ICU-associated GNB infections. This guideline is a potential antibiotic-sparing alternative to currently recommended dual empirical courses extending to ≥7 days.
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More information
Accepted/In Press date: 30 January 2014
e-pub ahead of print date: 25 February 2014
Published date: 2014
Identifiers
Local EPrints ID: 479254
URI: http://eprints.soton.ac.uk/id/eprint/479254
ISSN: 0305-7453
PURE UUID: a3ae6762-faf6-45b5-ad52-98ddd2f8cdd1
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Date deposited: 20 Jul 2023 16:48
Last modified: 17 Mar 2024 04:23
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Contributors
Author:
J.D. Edgeworth
Author:
I.C. Ster
Author:
D. Wyncoll
Author:
M. Shankar-Hari
Author:
C.A. McKenzie
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