dc.creator | Retamar Gentil, Pilar | |
dc.creator | Portillo, María M. | |
dc.creator | López-Prieto, María Dolores | |
dc.creator | Rodríguez López, Fernando Carlos | |
dc.creator | Cueto López, Marina de | |
dc.creator | García, María V. | |
dc.creator | Gómez, María J. | |
dc.creator | Arco, Alfonso del | |
dc.creator | Muñoz, Ángel | |
dc.creator | Sánchez-Porto, Antonio | |
dc.creator | Torres-Tortosa, Manuel | |
dc.creator | Martín-Aspas, Andrés | |
dc.creator | Arroyo, Ascensión | |
dc.creator | García-Figueras, Carolina | |
dc.creator | Acosta, Federico | |
dc.creator | Corzo, Juan E. | |
dc.creator | León-Ruiz, Laura | |
dc.creator | Escobar-Lara, Trinidad | |
dc.creator | Rodríguez-Baño, Jesús | |
dc.date.accessioned | 2016-03-11T19:55:24Z | |
dc.date.available | 2016-03-11T19:55:24Z | |
dc.date.issued | 2012 | |
dc.identifier.issn | 0066-4804 | es |
dc.identifier.uri | http://hdl.handle.net/11441/38449 | |
dc.description.abstract | The impact of the adequacy of empirical therapy on outcome for patients with bloodstream infections (BSI) is key for determin-
ing whether adequate empirical coverage should be prioritized over other, more conservative approaches. Recent systematic
reviews outlined the need for new studies in the field, using improved methodologies. We assessed the impact of inadequate
empirical treatment on the mortality of patients with BSI in the present-day context, incorporating recent methodological rec-
ommendations. A prospective multicenter cohort including all BSI episodes in adult patients was performed in 15 hospitals in
Andalucía, Spain, over a 2-month period in 2006 to 2007. The main outcome variables were 14- and 30-day mortality. Adjusted
analyses were performed by multivariate analysis and propensity score-based matching. Eight hundred one episodes were in-
cluded. Inadequate empirical therapy was administered in 199 (24.8%) episodes; mortality at days 14 and 30 was 18.55% and
22.6%, respectively. After controlling for age, Charlson index, Pitt score, neutropenia, source, etiology, and presentation with
severe sepsis or shock, inadequate empirical treatment was associated with increased mortality at days 14 and 30 (odds ratios
[ORs], 2.12 and 1.56; 95% confidence intervals [95% CI], 1.34 to 3.34 and 1.01 to 2.40, respectively). The adjusted ORs after a
propensity score-based matched analysis were 3.03 and 1.70 (95% CI, 1.60 to 5.74 and 0.98 to 2.98, respectively). In conclusion,
inadequate empirical therapy is independently associated with increased mortality in patients with BSI. Programs to improve
the quality of empirical therapy in patients with suspicion of BSI and optimization of definitive therapy should be implemented | es |
dc.format | application/pdf | es |
dc.language.iso | eng | es |
dc.publisher | American Society for Microbiology | es |
dc.relation.ispartof | Antimicrobial Agents and Chemotherapy 56 (1), 472-478 | es |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internacional | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
dc.subject | Antibacterianos | es |
dc.subject | Agranulocitosis | es |
dc.subject | Bacteriemia | es |
dc.subject | Farmacorresistencia bacteriana | es |
dc.subject | Errores médicos | es |
dc.subject | Pruebas de sensibilidad microbiana | es |
dc.title | Impact of Inadequate Empirical Therapy on the Mortality of Patients with Bloodstream Infections: a Propensity Score-Based Analysis | es |
dc.type | info:eu-repo/semantics/article | es |
dcterms.identifier | https://ror.org/03yxnpp24 | |
dc.type.version | info:eu-repo/semantics/publishedVersion | es |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | es |
dc.contributor.affiliation | Universidad de Sevilla. Departamento de Medicina | es |
dc.relation.publisherversion | http://aac.asm.org/content/56/1/472.abstract | es |
dc.identifier.doi | http://dx.doi.org/10.1128/AAC.00462-11 | es |
dc.identifier.idus | https://idus.us.es/xmlui/handle/11441/38449 | |