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• W1966853663 abstract "Abstract. Leibovici L, Shraga I, Drucker M, Konigsberger H, Samra Z, Pitlik SD (Rabin Medical Center, Petah-Tiqva, and Tel-Aviv University, Tel-Aviv, Israel). The benefit of appropriate empirical antibiotic treatment in patients with bloodstream infection. J Intern Med 1998; 244: 379–86. Objectives To test whether empirical antibiotic treatment that matches the in vitro susceptibility of the pathogen (appropriate treatment) improves survival in patients with bloodstream infections; and to measure the improvement. Design Observational, prospective cohort study. Setting University hospital in Israel. Subjects All patients with bloodstream infections detected during 1988–94. Interventions None. Main outcome measures In-hospital fatality rate and length of hospitalization. Results Out of 2158 patients given appropriate empirical antibiotic treatment, 436 (20%) died, compared with 432 of 1255 patients (34%) given inappropriate treatment (P = 0.0001). The median durations of hospital stay for patients who survived were 9 days for patients given appropriate treatment and 11 days for patients given inappropriate treatment. For patients who died, the median durations were 5 and 4 days, respectively (P < 0.05), for both comparisons. In a stratified analysis, fatality was higher in patients given inappropriate treatment than in those given appropriate treatment in all strata but two: patients with infections caused by streptococci other than Streptococcus gr. A and Streptoccocus pneumoniae (odds ratio (OR) of 1.0, 95% confidence interval (95% CI) 0.4–2.5); and hypothermic patients (OR = 0.9, 95% CI = 0.3–2.4). Even in patients with septic shock, inappropriate empirical treatment was associated with higher fatality rate (OR = 1.6, 95% CI = 1.0–2.7). The highest benefit associated with appropriate treatment was observed in paediatric patients (OR = 5.1, 95% CI = 2.4– 10.7); intra-abdominal infections (OR = 3.8, 95% CI = 2.0–7.1); infections of the skin and soft tissues (OR = 3.1, 95% CI = 1.8–5.6); and infections caused by Klebsiella pneumoniae (OR = 3.0, 95% CI = 1.7–5.1) and S. pneumoniae (OR = 2.6, 95% C = 1.1–5.9). On a multivariable logistic regression analysis, the contribution of inappropriate empirical treatment to fatality was independent of other risk factors (multivariable adjusted OR = 1.6, 95% CI = 1.3–1.9). Conclusion Appropriate empirical antibiotic treatment was associated with a significant reduction in fatality in patients with bloodstream infection." @default.
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• W1966853663 date "1998-11-01" @default.
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• W1966853663 title "The benefit of appropriate empirical antibiotic treatment in patients with bloodstream infection" @default.
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• W1966853663 doi "https://doi.org/10.1046/j.1365-2796.1998.00379.x" @default.
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