Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-30T21:39:18.941Z Has data issue: false hasContentIssue false

Guideline-Concordant Versus Discordant Antimicrobial Therapy in Patients With Community-Onset Complicated Intra-abdominal Infections

Published online by Cambridge University Press:  29 March 2016

Lori L. Huang
Affiliation:
Veterans’ Affairs Medical Center, Patient Care Services, Ann Arbor, Michigan University of Nebraska Medical Center, College of Pharmacy, Omaha, Nebraska
Trevor C. Van Schooneveld
Affiliation:
University of Nebraska Medical Center, College of Medicine, Omaha, Nebraska Nebraska Medicine, Department of Infection Control and Epidemiology, Omaha, Nebraska
Robert D. Huang
Affiliation:
University of Nebraska Medical Center, College of Medicine, Omaha, Nebraska University of Michigan, Emergency Medicine, Ann Arbor, Michigan
Keith M. Olsen
Affiliation:
University of Nebraska Medical Center, College of Pharmacy, Omaha, Nebraska
Mark E. Rupp
Affiliation:
University of Nebraska Medical Center, College of Medicine, Omaha, Nebraska Nebraska Medicine, Department of Infection Control and Epidemiology, Omaha, Nebraska
Alan E. Gross*
Affiliation:
University of Nebraska Medical Center, College of Pharmacy, Omaha, Nebraska University of Nebraska Medical Center, College of Medicine, Omaha, Nebraska University of Illinois at Chicago College of Pharmacy, Department of Pharmacy Practice, Chicago, Illinois University of Illinois Hospital and Health Sciences System, Chicago, Illinois.
*
Address correspondence to Alan E. Gross, 833 South Wood Street, 164 PHARM, Chicago, IL 60612 ([email protected]).

Abstract

Overall IDSA/SIS intra-abdominal infection guideline compliance was not associated with improved outcomes; however, there was a longer time to active therapy (P=.024) and higher mortality (P=.077) if empiric therapy was too narrow per guidelines. These findings support the need for the implementation of customized institutional guidelines adapted from the IDSA/SIS guidelines.

Infect Control Hosp Epidemiol 2016;37:855–858

Type
Concise Communications
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

PREVIOUS PRESENTATION. This study was presented in part as a poster (#1939) at the Interscience Conference on Antimicrobial Agents and Chemotherapy in Denver, Colorado, on September 13, 2013.

References

REFERENCES

1. Brun-Bulsson, C, Boyon, F, Carlet, J, et al. Incidence, risk factors, and outcome of severe sepsis and septic shock in adults. A multicenter prospective study in intensive care units. French ICU Group for Severe Sepsis. JAMA 1995;274:968974.Google Scholar
2. Paul, M, Shani, V, Muchtar, E, Kariv, G, Robenshtok, E, Leibovici, L. Systematic review and meta-analysis of the efficacy of appropriate empiric antibiotic therapy for sepsis. Antimicrob Agents Chemother 2010;54:48514863.CrossRefGoogle ScholarPubMed
3. Sturkenboom, MC, Goettsch, WG, Picelli, G. Inappropriate initial treatment of secondary intra-abdominal infections leads to increased risk of clinical failure and costs. BR J Clin Pharmacol 2005;60:438443.CrossRefGoogle ScholarPubMed
4. Sartelli, M, Catena, F, Coccolini, F, Pinna, AD. Antimicrobial management of intra-abdominal infections: literature’s guidelines. World J Gastroenterol 2012;18:865871.CrossRefGoogle ScholarPubMed
5. Solomkin, JS, Mazuski, JR, Bradley, JS, et al. IDSA guidelines for the management of complicated intra-abdominal infections in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Clin Infect Dis 2010;50:133164.Google Scholar
6. Vincent, JL, Moreno, R, Takala, J, et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med 1996;22:707710.Google Scholar
7. Shlaes, DM, Gerding, DN, John, JF, et al. Society for Healthcare Epidemiology of America and Infectious Diseases Society of America Joint Committee on the Prevention of Antimicrobial Resistance: guidelines for the prevention of antimicrobial resistance in hospitals. Clin Infect Dis 1997;25:584599.Google Scholar
8. Kurup, A, Liau, K, Ren, J, et al. Antibiotic management of complicated intra-abdominal infections in adults: The Asian perspective. Ann Med Surg (Lond) 2014;3:8591.Google Scholar
9. Dubrovskaya, Y, Papadopoulus, J, Scipione, MR, Altshuler, J, Phillips, M, Mehta, SA. Antibiotic stewardship for intra-abdominal infections early impact on antimicrobial use and patient outcomes. Infect Control Hosp Epidemiol 2012;33:426429.CrossRefGoogle ScholarPubMed
10. Popovski, Z, Mercuri, M, Main, C, et al. Multifaceted intervention to optimize antibiotic use for intra-abdominal infections. J Antimicrob Chemother 2015;70:12261229.Google Scholar