Antibiotic therapy and outcome of monomicrobial gram-negative bacteraemia: a 3-year population-based study

Scand J Infect Dis. 1997;29(6):601-6. doi: 10.3109/00365549709035903.

Abstract

Within the 3-y period 1992-94 a total of 815 episodes of monomicrobial bacteraemia caused by Enterobacteriaceae not including Salmonella were registered in the County of Northern Jutland. The 30-d case fatality rate was 24%, ranging from 21% for Enterobacter spp. (n = 43), 22% for E. coli (n = 577) to 32% for both Klebsiella spp. (n = 138) and a group of miscellaneous enterobacteria (n = 57). In 16% of the bacteraemias, antibiotic treatment was not instituted before notification of positive blood cultures; in 9% empirical antibiotic treatment was inappropriate. Antibiotic regimens mainly included beta-lactams, ampicillin or mecillinam in combination with an aminoglycoside. The following factors were independently associated with case fatality: age > or = 75 y, high comorbidity index, admission to a medical ward or an intensive care unit, nosocomial acquisition, a source of infection outside the urinary tract or an undetermined focus, Klebsiella spp., inappropriate coverage or lack of antibiotic treatment before notification of positive blood culture. It is a matter of concern that in one-sixth of patients the physicians had not responded to the possibility of bacteraemia with institution of empirical antibiotic therapy.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use*
  • Bacteremia / drug therapy*
  • Bacteremia / epidemiology
  • Denmark / epidemiology
  • Enterobacteriaceae Infections / drug therapy*
  • Female
  • Gram-Negative Bacterial Infections / drug therapy
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Salmonella Infections / drug therapy
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents