Your browser doesn't support javascript.
loading
Short-course aminoglycosides as adjunctive empirical therapy in patients with Gram-negative bloodstream infection, a cohort study.
Deelen, J W Timotëus; Rottier, W C; Buiting, A G M; Dorigo-Zetsma, J W; Kluytmans, J A J W; van der Linden, P D; Thijsen, S F T; Vlaminckx, B J M; Weersink, A J L; Ammerlaan, H S M; Bonten, M J M; van Werkhoven, C H.
Afiliación
  • Deelen JWT; Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands. Electronic address: j.w.t.deelen@umcutrecht.nl.
  • Rottier WC; Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands.
  • Buiting AGM; Laboratory for Medical Microbiology and Immunology, Elisabeth-TweeSteden Hospital, Tilburg, Waalwijk, the Netherlands.
  • Dorigo-Zetsma JW; Central Laboratory for Bacteriology and Serology, Tergooi Hospitals, Hilversum, the Netherlands.
  • Kluytmans JAJW; Laboratory for Microbiology and Infection Control, Amphia Hospital, Breda, the Netherlands.
  • van der Linden PD; Department of Clinical Pharmacy, Tergooi Hospitals, Hilversum, the Netherlands.
  • Thijsen SFT; Department of Medical Microbiology and Immunology, Diakonessenhuis, Utrecht, the Netherlands.
  • Vlaminckx BJM; Department of Medical Microbiology and Immunology, St. Antonius Hospital, Utrecht, Nieuwegein, the Netherlands.
  • Weersink AJL; Laboratory for Medical Microbiology and Immunology, Meander Medical Center, Amersfoort, the Netherlands.
  • Ammerlaan HSM; Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands; Department of Internal Medicine, Catharina Hospital, Eindhoven, the Netherlands.
  • Bonten MJM; Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands; Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, the Netherlands.
  • van Werkhoven CH; Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands.
Clin Microbiol Infect ; 27(2): 269-275, 2021 Feb.
Article en En | MEDLINE | ID: mdl-32387438
OBJECTIVE: Short-course aminoglycosides as adjunctive empirical therapy to ß-lactams in patients with a clinical suspicion of sepsis are used to broaden antibiotic susceptibility coverage and to enhance bacterial killing. We quantified the impact of this approach on 30-day mortality in a subset of sepsis patients with a Gram-negative bloodstream infection. METHODS: From a prospective cohort study conducted in seven hospitals in the Netherlands between June 2013 and November 2015, we selected all patients with Gram-negative bloodstream infection (GN-BSI). Short-course aminoglycoside therapy was defined as tobramycin, gentamicin or amikacin initiated within a 48-hour time window around blood-culture obtainment, and prescribed for a maximum of 2 days. The outcome of interest was 30-day all-cause mortality. Confounders were selected a priori for adjustment using a propensity score analysis with inverse probability weighting. RESULTS: A total of 626 individuals with GN-BSI who received ß-lactams were included; 156 (24.9%) also received aminoglycosides for a median of 1 day. Patients receiving aminoglycosides more often had septic shock (31/156, 19.9% versus 34/470, 7.2%) and had an eight-fold lower risk of inappropriate treatment (3/156, 1.9% versus 69/470, 14.7%). Thirty-day mortality was 17.3% (27/156) and 13.6% (64/470) for patients receiving and not receiving aminoglycosides, respectively; yielding crude and adjusted odds ratios for 30-day mortality for patients treated with aminoglycosides of 1.33 (95% CI 0.80-2.15) and 1.57 (0.84-2.93), respectively. CONCLUSIONS: Short-course adjunctive aminoglycoside treatment as part of empirical therapy with ß-lactam antibiotics in patients with GN-BSI did not result in improved outcomes, despite better antibiotic coverage of pathogens.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por Bacterias Gramnegativas / Sepsis / Beta-Lactamas / Aminoglicósidos Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Clin Microbiol Infect Asunto de la revista: DOENCAS TRANSMISSIVEIS / MICROBIOLOGIA Año: 2021 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por Bacterias Gramnegativas / Sepsis / Beta-Lactamas / Aminoglicósidos Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Clin Microbiol Infect Asunto de la revista: DOENCAS TRANSMISSIVEIS / MICROBIOLOGIA Año: 2021 Tipo del documento: Article Pais de publicación: Reino Unido