Predictors for delayed antibiotic administration among bacteraemic patients in the Emergency Department: Differences between medical and surgical interns.

Details

Serval ID
serval:BIB_B523FA65A8E7
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Predictors for delayed antibiotic administration among bacteraemic patients in the Emergency Department: Differences between medical and surgical interns.
Journal
European journal of clinical investigation
Author(s)
Papadimitriou-Olivgeris M., Perdikis K., Cois M., Roth L., Mykoniati S., Nusbaumer C., Monnerat L.B., Duplain H.
ISSN
1365-2362 (Electronic)
ISSN-L
0014-2972
Publication state
Published
Issued date
11/2020
Peer-reviewed
Oui
Volume
50
Number
11
Pages
e13324
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Bloodstream infections (BSIs) have been associated with high mortality. The aim of the study was to identify predictors of early (within 3 hours from triage) administration of first antibiotic dose among patients evaluated in the Emergency Department (ED) with BSI and their role in mortality.
All adult patients with BSI at the ED of the Hospital of Jura, Switzerland during a 3 year period (July 2014 to June 2017) were included.
Among 364 BSI, the most common sites of infection were urinary tract (39.6% of BSIs), lower respiratory tract (15.4%), intra-abdominal (15.4%) and primary BSI (9.1%). One-hundred-seventy-eight patients (48.9%) received the first antibiotic dose within 3 hours from triage. Multivariate analysis identified evaluation by internal medicine intern, triage scales 1 and 2, as predictors of early antibiotic administration, while, primary BSI was associated with delayed antibiotic administration. Thirty-day mortality was 12.9% (47 patients). Charlson comorbidity index, septic shock, low respiratory tract infection were independently associated with mortality, while antibiotic administration within 3 hours from triage and source control within 48 hours from triage were associated with survival.
The majority of patients received the first antibiotic dose after 3 hours Patients evaluated by surgical interns had a significant delay in administration of antibiotics as compared to those treated by medical interns.
Keywords
Aged, Aged, 80 and over, Anti-Bacterial Agents/therapeutic use, Bacteremia/diagnosis, Bacteremia/drug therapy, Blood Culture, Emergency Service, Hospital, Female, General Surgery/education, General Surgery/statistics & numerical data, Humans, Internal Medicine/education, Internal Medicine/statistics & numerical data, Internship and Residency/statistics & numerical data, Intraabdominal Infections/diagnosis, Intraabdominal Infections/drug therapy, Male, Middle Aged, Mortality, Organ Dysfunction Scores, Respiratory Tract Infections/diagnosis, Respiratory Tract Infections/drug therapy, Risk Factors, Sepsis/diagnosis, Sepsis/drug therapy, Switzerland, Time-to-Treatment/statistics & numerical data, Triage, Urinary Tract Infections/diagnosis, Urinary Tract Infections/drug therapy, antibiotic timing, bacteraemia, bloodstream infection, mortality, sepsis, septic shock
Pubmed
Web of science
Create date
06/07/2020 12:04
Last modification date
25/12/2022 6:51
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