AJM Theme Issue: Infectious DiseaseClinical research studyBenefit of Appropriate Empirical Antibiotic Treatment: Thirty-day Mortality and Duration of Hospital Stay
Section snippets
Study Sample
We analyzed a multinational database of patients from 3 medical centers: Rabin Medical Center, Beilinson Campus (Israel): 6 departments of internal medicine (240 beds); University Hospital of Freiburg (Germany): 2 gastroenterology, 2 nephrology, and 2 intensive care wards (94 beds); and A. Gemelli University Hospital (Italy): 3 infectious disease wards (60 beds). Patients were enrolled as part of a 2-phase study (observational and interventional) designed to evaluate the effectiveness of TREAT,
Results
Of the 3529 recruited patients, 920 (26%) had microbiologically documented infections and mortality data were available for 895 (97.3% of 920). A total of 560 patients were enrolled in Israel, 180 patients were enrolled in Germany, and 155 patients were enrolled in Italy. A total of 435 patients were female (49%). The mean age was 66.7 ± 18.2 years (standard deviation). A total of 182 infections were hospital acquired (20%). The most common sites of infection were the urinary tract (315 patients,
Discussion
We found inappropriate empirical antibiotic treatment to be associated with an increased risk for all-cause 30-day mortality in adult patients with bacterial infections hospitalized in three medical centers in three different countries (OR = 1.58, 95% CI, 0.99-2.54). Although this association has been found in subsets of patients (critically ill patients3, 4, 6, 8, 9and patients with bloodstream infections2, 5, 7), our results demonstrate that this association is also true of inpatients with
Treat study group
Leonard Leibovici and Steen Andreassen conceived the TREAT project and basic concepts.
Mical Paul, Leonard Leibovici, Brian Kristensen, Elad Goldberg, Anders D. Nielsen, Alina Zalounina, and Steen Andreassen built the model.
Leif E. Kristensen, Karsten Falborg, Alina Zalounina, and Anders D. Nielsen built the interface, database, and supporting software.
Abigail Fraser, Mical Paul, and Leonard Leibovici planned this study and analyzed data.
Abigail Fraser, Mical Paul, Nadja Almanasreh, Evelina
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