Table 3 Assessment of the appropriateness of antimicrobial therapy for microbiologically documented infections
From: Strategies of initiation and streamlining of antibiotic therapy in 41 French intensive care units
Parameter | Appropriate AT | Inappropriate AT | P |
|---|---|---|---|
(n = 203) | (n = 58) | ||
AT protocol available in the ICU | 79 (61.1%) | 35 (60.3%) | 0.91 |
Timing of new AT prescription | |||
Day shifts | 97 (47.8%) | 30 (51.7%) | 0.59 |
Out-of-hours | 106 (52.2%) | 28 (48.3%) | |
Category of MD prescriber | |||
Fellow | 17 (8,4%) | 7 (12.1%) | 0.88 |
Senior physician | 148 (72.9%) | 41 (70.7%) | |
Medical team decision | 38 (18.7%) | 10 (17.2%) | |
Time of initiation of new AT | |||
Suspicion of infection | 120 (59.1%) | 29 (50.0%) | |
Gram-stained direct examination available | 65 (32.0%) | 12 (20.7%) | <0.0001 |
Microbiologic identification available | 18 (8.9%) | 3 (5.2%) | |
Susceptibility testing available | 0 | 14 (24.4%) | |
Change of AT | |||
None | 107 (52.7%) | 14 (24.1%) | |
Gram-stained direct examination available | 11 (5.4%) | 4 (6.9%) | 0.001 |
Microbiologic identification available | 32 (15.8%) | 11 (19.0%) | |
Susceptibility testing available | 53 (26.1%) | 29 (50.0%) | |
Number of AT changes | 0.5 ± 0.6 | 0.9 ± 0.7 | 0.05 |
Non-microbiologic reason for AT change | 38 (18.7%) | 10 (17.2%) | 0.79 |
Clinical worsening | 4 (2.0%) | 1 (1.7%) | |
New site of infection | 5 (2.5%) | 4 (6.9%) | |
Aminoglycoside stopped | 23 (11.3%) | 4 (6.9%) | |
AB side effect | 3 (1.5%) | 1 (1.7%) | |
De-escalation | 26 (12.8%) | 4 (6.9%) |