Effects of antibiotic administration delay and inadequacy upon the survival of septic shock patients
Effects of antibiotic administration delay and inadequacy upon the survival of septic shock patients
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DOI：
10.1016/j.medin.2014.12.006
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发表时间：
2015-11-01
影响因子：
3
通讯作者：
Castellanos-Ortega, A.
中科院分区：
文献类型：
--
作者：
Canus, B. Suberviola;Jauregui, R.;Castellanos-Ortega, A.
目的：评估抗生素给药延迟和不足如何影响感染性休克患者的生存率。设计：2005年9月至2010年9月进行了一项前瞻性观察性队列研究。范围：三级医院ICU收治的患者。患者：共342例感染性休克患者。干预措施：无相关变量：抗生素给药时间（脓毒性休克表现与首次给予抗生素剂量之间的差异）及其充分性结果：ICU病死率为26.4%，住院病死率为33.5%。首次抗生素给药的中位延迟时间为1.7小时。死亡患者接受抗生素治疗的时间明显晚于存活患者（1.3 +/- 14.5 h vs. 5.8 +/- 18.02 h; P= 0.001）。药物不足的百分比为12%。抗生素使用不足的患者死亡率明显更高（33.8% vs. 51.2%; P= 0.03）。结论：抗生素给药延迟和不足均对感染性休克患者的生存产生有害影响，与其特征或严重程度无关（C）2015 Elsevier Espana，S.L.U.半导体。All rights reserved.
Objective: To assess how antibiotic administration delay and inadequacy influence survival in septic shock patients.Design: A prospective, observational cohort study was carried out between September 2005 and September 2010.Scope: Patients admitted to the ICU of a third level hospital.Patients: A total of 342 septic shock patientsInterventions: NoneVariables of interest: The time to antibiotic administration (difference between septic shock presentation and first administered dose of antibiotic) and its adequacy (in vitro susceptibility testing of isolated pathogens) were determined.Results: ICU and hospital mortality were 26.4% and 33.5%, respectively. The median delay to administration of the first antibiotic dose was 1.7 h. Deceased patients received antibiotics significantly later than survivors (1.3 +/- 14.5 h vs. 5.8 +/- 18.02 h; P=.001). Percentage drug inadequacy was 12%. Those patients who received inadequate antibiotics had significantly higher mortality rates (33.8% vs. 51.2%; P=.03). The coexistence of treatment delay and inadequacy was associated to lower survival rates.Conclusions: Both antibiotic administration delay and inadequacy exert deleterious effects upon the survival of septic shock patients, independently of their characteristics or severity (C) 2015 Elsevier Espana, S.L.U. and SEMICYUC. All rights reserved.