Inappropriate empirical antimicrobial treatment in bloodstream infections patients in the era of multidrug resistance

Jane Eire Urzedo, Ralciane de Paula Menezes, Melina Lorraine Ferreira, Cristiane Silveira De Brito, Raquel Cristina Cavalcanti Dantas, Paulo Pinto Gontijo Filho, Rosineide Marques Ribas
2022 Revista de Epidemiologia e Controle de Infecção  
and objectives: Bloodstream infection (BSI) by multidrug-resistant Pseudomonas aeruginosa is a severe infection. This study aimed to evaluate and identify the predictors of mortality in patients who had bloodstream infection by carbapenem-resistant P. aeruginosa. Methods: This is a retrospective cohort study, approved by Committee of Ethics in Research with Human Participants, which included 87 consecutive patients hospitalized in a referral hospital in Brazil. Clinical and demographic
more » ... on about each patient were obtained from hospital records. The Student's T-test was used to compare continuous variables and x2 or Fisher's exact tests to compare categorical variables. To determine independent risk factors for 30-day mortality, a multiple logistic regression model was used. A survival curve was constructed using the Kaplan–Meier method. Results: Among the patients, 87.3% use antibiotics previously, 60.9% received inadequate empirical treatment, and the 30-day mortality rate was 57.5%. Inappropriate antibiotic empirical therapy was independently associated with a 30-days death and mortality rate. Conclusion: These findings can show some insights about the relationship between higher mortality and inappropriate empirical therapy for patients with BSI by P. aeruginosa. There is a need for better diagnostic tests and infection control programs should focus on de-escalation the antibiotic inappropriate therapy, mainly in BSI caused by carbapenem-resistant P. aeruginosa.
doi:10.17058/reci.v12i2.16855 fatcat:neeyqiqrjveivdrtoh3p7ctzki