Our study assessed the effects of empiric antibiotics with different degrees of appropriateness based on hospital cumulative antibiograms in sepsis patients with bacteremia presenting to the emergency department (ED).
This retrospective cohort study included adult sepsis patients with positive blood culture reports in the ED from February 2016 to December 2018. Based on the isolated pathogens and empiric antibiotics the patients received, these patients were divided into two groups by using a cutoff of 70% for overall antimicrobial susceptibility (OAS) on the hospital cumulative antibiograms 6 months prior to this ED admission. Multivariate regression and sensitivity analyses were performed.
1055 patients were included. We used multivariate regression models which adjusted for age, sex, comorbidities, sites of infection, organ dysfunction, and septic shock. Empiric antibiotics with OAS 70% and above was associated with reduced in-hospital death (adjusted odds ratio [aOR] 0.46, 95% confidence interval [CI] 0.28 – 0.77) and 30-day mortality (aOR 0.53, 95% CI 0.33 – 0.86). They were more likely to have a shortened length of intensive care unit (ICU) stay by 1.60 days (95% CI -3.00 – -0.20).
Empiric antibiotic treatment with OAS 70% and above based on hospital cumulative antibiograms is associated with lower mortality and shorter length of ICU stay in sepsis patients with bacteremia in the ED.

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