Optimization of empirical antibiotic selection for suspected Gram-negative bacteraemia in the emergency department

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• 作者：Benenson ; Shmuel ; Yinnon ; Amos M. ; Schlesinger ; Yechiel ; Rudensky ; Bernard ; Raveh ; David
• 关键词：Bacteraemia ; Gram-negative bacteria ; Empirical therapy
• 刊名：International Journal of Antimicrobial Agents
• 出版年：2005
• 出版时间：May, 2005
• 年：2005
• 卷：25
• 期：5
• 页码：398-403
• 全文大小：108 K

文摘

A 1-year prospective study of patients with a positive blood culture and admitted through the emergency department (ED), was conducted to detect incidence and risk factors for resistance of Enterobacteriaceae to gentamicin and ciprofloxacin. A total of 245 emergency department-admitted patients had positive blood cultures, of which 131 (54 % ) grew Enterobacteriaceae. Of these 131 isolates, 32 (24 % ) were resistant to gentamicin and 37 (28 % ) to ciprofloxacin. Risk factors, by multivariate analysis, for gentamicin and ciprofloxacin resistance were: male gender (P < 0.05 and P < 0.01, respectively), nursing home residence (P < 0.001), diabetes mellitus (P < 0.05) and presence of a foreign body (P < 0.05 and P < 0.005). An additional risk factor for ciprofloxacin resistance was recent hospitalisation (P < 0.05). These data facilitate optimal selection of empirical antibiotic treatment of suspected Gram-negative infections, and may contribute to improved patient outcome and optimal use of antibiotics.