Timing of appropriate empirical antimicrobial administration and outcome of adults with community-onset bacteremia

Lee, Ching-Chi; Lee, Chung-Hsun; Hong, Ming-Yuan; Tang, Hung-Jen; Ko, Wen-Chien

doi:10.1186/s13054-017-1696-z

Critical Care

Table 3 Critical illness, fatal comorbidities, and 28-day mortality rates among adults with community-onset bacteremia

From: Timing of appropriate empirical antimicrobial administration and outcome of adults with community-onset bacteremia

TtAa cutoffs (number of cases)	Percentage (number of cases)		28-day Mortality rate (number of cases)	Univariate analysis		Cox regression
TtAa cutoffs (number of cases)	Critical illness^a	Fatal comorbidity	28-day Mortality rate (number of cases)	OR (95% CI)	P value	AOR (95% CI)^b	P value
1 hour
≤1 (n = 1663)	16.5 (275)	22.4 (373)	10.3 (172)	0.36 (0.28–0.45)	<0.001	0.57 (0.46–0.71)	<0.001
>1 (n = 686)	29.3 (201)	27.8 (191)	24.5 (168)	0.36 (0.28–0.45)	<0.001	0.57 (0.46–0.71)	<0.001
6 hours
≤6 (n = 1736)	19.0 (329)	23.1 (401)	12.0 (208)	0.50 (0.39–0.63)	<0.001	0.65 (0.51–0.82)	<0.001
>6 (n = 613)	24.0 (147)	26.6 (163)	21.5 (132)	0.50 (0.39–0.63)	<0.001	0.65 (0.51–0.82)	<0.001
12 hours
≤12 (n = 1760)	19.4 (341)	23.4 (412)	12.3 (216)	0.53 (0.41–0.67)	<0.001	0.65 (0.52–0.83)	<0.001
>12 (n = 589)	22.9 (135)	25.8 (152)	21.1 (124)	0.53 (0.41–0.67)	<0.001	0.65 (0.52–0.83)	<0.001
24 hours
≤24 (n = 1,853)	19.8 (367)	23.5 (436)	12.6 (234)	0.53 (0.41–0.69)	<0.001	0.62 (0.48–0.79)	<0.001
>24 (n = 496)	22.0 (109)	25.8 (128)	21.4 (106)	0.53 (0.41–0.69)	<0.001	0.62 (0.48–0.79)	<0.001
48 hours
≤48 (n = 1,917)	19.8 (380)	23.5 (450)	12.5 (240)	0.48 (0.37–0.62)	<0.001	0.54 (0.43–0.71)	<0.001
>48 (n = 432)	22.2 (96)	26.4 (114)	23.1 (100)	0.48 (0.37–0.62)	<0.001	0.54 (0.43–0.71)	<0.001
72 hours
≤72 (n = 1,981)	19.5 (387)	23.4 (463)	12.6 (249)	0.44 (0.33–0.57)	<0.001	0.55 (0.43–0.71)	<0.001
>72 (n = 368)	24.2 (89)	27.4 (101)	24.7 (91)	0.44 (0.33–0.57)	<0.001	0.55 (0.43–0.71)	<0.001
96 hours
≤96 (n = 2,061)	19.4 (400)	23.5 (484)	12.8 (264)	0.41 (0.31–0.55)	<0.001	0.56 (0.44–0.72)	<0.001
>96 (n = 288)	26.4 (76)	27.8 (80)	26.4 (76)	0.41 (0.31–0.55)	<0.001	0.56 (0.44–0.72)	<0.001

The significance of the effects of different cutoffs of the time to appropriate antibiotic (TtAa) on 28-day mortality were examined by univariate and Cox regression analyses. OR odds ratio, CI confidence interval, AOR adjusted odds ratio. ^aPitt bacteremia score ≥4 on arrival at the emergency department. ^bAdjusted for independent predictors of 28-day mortality recognized in the multivariate regression: critical illness; a fatal comorbidity (McCabe classification); polymicrobial bacteremia; Extended-spectrum beta-lactamase-producing bacteremia; bacteremia because of pneumonia or urinary tract infections; and underlying malignancy or liver cirrhosis

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ISSN: 1364-8535

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