Appropriate empirical antibiotic use and 30-d mortality in cirrhotic patients with bacteremia.

Publisher: Baishideng Publishing Group Country of Publication: United States NLM ID: 100883448 Publication Model: Print Cited Medium: Internet ISSN: 2219-2840 (Electronic) Linking ISSN: 10079327 NLM ISO Abbreviation: World J Gastroenterol Subsets: MEDLINE

Publication: 2014- : Pleasanton, CA : Baishideng Publishing Group
Original Publication: Beijing : WJG Press, c1998-

Inappropriate Prescribing*; Anti-Bacterial Agents/*therapeutic use ; Bacteremia/*drug therapy ; Liver Cirrhosis/*complications; Aged ; Bacteremia/diagnosis ; Bacteremia/microbiology ; Bacteremia/mortality ; Drug Resistance, Multiple, Bacterial ; Female ; Humans ; Kaplan-Meier Estimate ; Liver Cirrhosis/diagnosis ; Liver Cirrhosis/mortality ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Predictive Value of Tests ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome

Aim: To analyze whether prompt and appropriate empirical antibiotic (AEA) use is associated with mortality in cirrhotic patients with bacteremia.
Methods: A total of 102 episodes of bacteremia in 72 patients with cirrhosis were analyzed. AEA was defined as a using or starting an antibiotic appropriate to the isolated pathogen at the time of bacteremia. The primary endpoint was 30-d mortality.
Results: The mortality rate at 30 d was 30.4% (31/102 episodes). Use of AEA was associated with better survival at 30 d (76.5% vs 46.9%, P = 0.05), and inappropriate empirical antibiotic (IEA) use was an independent factor associated with increased mortality (OR = 3.24; 95%CI: 1.50-7.00; P = 0.003, adjusted for age, sex, Child-Pugh Class, gastrointestinal bleeding, presence of septic shock). IEA use was more frequent when the isolated pathogen was a multiresistant pathogen, and when infection was healthcare-related or hospital-acquired.
Conclusion: AEA use was associated with increased survival of cirrhotic patients who developed bacteremia. Strategies for AEA use, tailored according to the local epidemiological patterns, are needed to improve survival of cirrhotic patients with bacteremia.

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Keywords: Appropriate antibiotics; Bacteremia; Liver cirrhosis; Multiresistant pathogen; Survival

0 (Anti-Bacterial Agents)

Date Created: 20150403 Date Completed: 20160120 Latest Revision: 20220311

20231215

PMC4375581

10.3748/wjg.v21.i12.3587

25834324