Antimicrobials administration time in patients with suspected sepsis: faster is better for severe patients

Jouffroy, Romain; Vivien, Benoît

doi:10.1186/s40560-020-00471-2

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…Beyond all the study limits and strengths, the current results need to be confirmed by larger prospective multicentric studies because recent extensive meta-analyses and randomized trials do not find such benefits (20,51,52) despite controversies (53)(54)(55). Furthermore, the use of the "hour 1 bundle" for sepsis management remains under debate, especially for the Infectious Disease Society of America who no longer endorse the use of the "hour 1 bundle" (10).…”

Section: Discussionmentioning

confidence: 90%

Prehospital Bundle of Care Based on Antibiotic Therapy and Hemodynamic Optimization Is Associated With a 30-Day Mortality Decrease in Patients With Septic Shock*

Jouffroy¹,

Gilbert

Tourtier

et al. 2022

Critical Care Medicine

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This study aims to investigate the association between the 30-day mortality in patients with septic shock (SS) and a prehospital bundle of care completion, antibiotic therapy administration, and hemodynamic optimization defined as a fluid expansion of at least 10 mL.kg −1 .hr −1 . DESIGN:To assess the association between prehospital BUndle of Care (BUC) completion and 30-day mortality, the inverse probability treatment weighting (IPTW) propensity method was performed. SETTING:International guidelines recommend early treatment implementation in order to reduce SS mortality. More than one single treatment, a bundle of care, including antibiotic therapy and hemodynamic optimization, is more efficient. PATIENTS:From May 2016 to March 2021, patients with SS requiring prehospital mobile ICU (mICU) intervention were retrospectively analyzed. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS:Among the 529 patients with SS requiring action by the mICU enrolled in this study, 354 (67%) were analyzed. Presumed pulmonary, digestive, and urinary infections were the cause of the SS in 49%, 25%, and 13% of the cases, respectively. The overall 30-day mortality was 32%. Seventy-one patients (20%) received prehospital antibiotic therapy and fluid expansion. Log binomial regression weighted with IPTW resulted in a significant association between 30-day mortality and prehospital BUC completion (respiratory rate [RR] of 0.56 [0.33-0.89]; p = 0.02 and adjusted RR 0.52 [0.27-0.93]; p = 0.03). CONCLUSIONS:A prehospital bundle of care, based on antibiotic therapy and hemodynamic optimization, is associated with a 30-day mortality decrease among patients suffering from SS cared for by an mICU.

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Section: Discussionmentioning

confidence: 90%

Prehospital Bundle of Care Based on Antibiotic Therapy and Hemodynamic Optimization Is Associated With a 30-Day Mortality Decrease in Patients With Septic Shock*

Jouffroy¹,

Gilbert

Tourtier

et al. 2022

Critical Care Medicine

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“…Previous studies from Colombia have also highlighted varying bacterial profiles and resistance patterns ( 9 – 11 ) and the importance of blood culture and antibiotic sensitivity testing, including the use of automated systems ( 6 , 12 – 14 ).…”

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confidence: 99%

Bloodstream infections and antibiotic resistance at a regional hospital, Colombia, 2019–2021

Saavedra

Fonseca²,

Abrahamyan³

et al. 2023

Revista Panamericana De Salud Pública

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Objectives. To assess antibiotic susceptibility of World Health Organization (WHO) priority bacteria (Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, Salmonella spp., Staphylococcus aureus, and Streptococcus pneumoniae) in blood cultures at the Orinoquía regional hospital in Colombia. Methods. This was cross-sectional study using routine laboratory data for the period 2019–2021. Data on blood samples from patients suspected of a bloodstream infection were examined. We determined: the total number of blood cultures done and the proportion with culture yield; the characteristics of patients with priority bacteria; and the type of bacteria isolated and antibiotic resistance patterns. Results. Of 25 469 blood cultures done, 1628 (6%) yielded bacteria; 774 (48%) of these bacteria were WHO priority pathogens. Most of the priority bacteria isolated (558; 72%) were gram-negative and 216 (28%) were gram-positive organisms. Most patients with priority bacteria (666; 86%) were hospitalized in wards other than the intensive care unit, 427 (55%) were male, and 321 (42%) were ≥ 60 years of age. Of the 216 gram-positive bacteria isolated, 205 (95%) were Staphylococcus aureus. Of the 558 gram-negative priority bacteria isolated, the three most common were Escherichia coli (34%), Klebsiella pneumoniae (28%), and Acinetobacter baumannii (20%). The highest resistance of Staphylococcus aureus was to oxacillin (41%). For gram-negative bacteria, resistance to antibiotics ranged from 4% (amikacin) to 72% (ampicillin). Conclusions. Bacterial yield from blood cultures was low and could be improved. WHO priority bacteria were found in all hospital wards. This calls for rigorous infection prevention and control standards and continued surveillance of antibiotic resistance.

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Une place centrale de l'infirmier à domicile pour le dépistage de la sévérité du sepsis

Alves¹,

Jouffroy²

2021

Soins

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Antimicrobials administration time in patients with suspected sepsis: faster is better for severe patients

Cited by 3 publications

References 5 publications

Prehospital Bundle of Care Based on Antibiotic Therapy and Hemodynamic Optimization Is Associated With a 30-Day Mortality Decrease in Patients With Septic Shock*

Prehospital Bundle of Care Based on Antibiotic Therapy and Hemodynamic Optimization Is Associated With a 30-Day Mortality Decrease in Patients With Septic Shock*

Bloodstream infections and antibiotic resistance at a regional hospital, Colombia, 2019–2021

Une place centrale de l'infirmier à domicile pour le dépistage de la sévérité du sepsis

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