scholarly journals Sepsis Incidence: A Population-Based Study

2016 ◽  
Vol 3 (4) ◽  
Author(s):  
Lisa Mellhammar ◽  
Sven Wullt ◽  
Åsa Lindberg ◽  
Peter Lanbeck ◽  
Bertil Christensson ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
Antibiotic Therapy ◽  
Organ Dysfunction ◽  
Antibiotic Treatment ◽  
Retrospective Chart Review ◽  
Population Based ◽  
Clinical Findings ◽  
Intravenous Antibiotic ◽  
Major Health Problem ◽  
Intravenous Antibiotic Therapy

Abstract Background Although sepsis is a major health problem, data on sepsis epidemiology are scarce. The aim of this study was to assess the incidence of sepsis, based on clinical findings in all adult patients treated with intravenous antibiotic in all parts of all hospitals in an entire population. Methods This is a retrospective chart review of patients ≥18 years, living in 2 regions in Sweden, who were started on an intravenous antibiotic therapy on 4 dates, evenly distributed over the year of 2015. The main outcome was the incidence of sepsis with organ dysfunction. The mean population ≥18 years at 2015 in the regions was 1275753. Five hundred sixty-three patients living in the regions were started on intravenous antibiotic treatment on the dates of the survey. Patients who had ongoing intravenous antibiotic therapy preceding the inclusion dates were excluded, if sepsis was already present. Results Four hundred eighty-two patients were included in the study; 339 had a diagnosed infection, of those, 96 had severe sepsis according to the 1991/2001 sepsis definitions, and 109 had sepsis according to the sepsis-3. This is equivalent to an annual incidence of traditional severe sepsis of 687/100000 persons (95% confidence interval [CI], 549–824) or according to the sepsis-3 definition of 780/100000 persons (95% CI, 633–926). Seventy-four patients had sepsis according to both definitions. Conclusions The incidence of sepsis with organ dysfunction is higher than most previous estimates independent of definition. The inclusion of all inpatients started on intravenous antibiotic treatment of sepsis in a population makes an accurate assessment of sepsis incidence possible.

Home intravenous antibiotic therapy

1993 ◽  
Vol 94 (1) ◽  
pp. 114 ◽  
Author(s):  
David T. Durack ◽  
A.W. Karchmer ◽  
Ralph Blair ◽  
auWalter Wilson ◽  
William Dismukes ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Intravenous Antibiotic ◽  
Intravenous Antibiotic Therapy

Management of complicated shunt infections: a clinical report

2008 ◽  
Vol 1 (3) ◽  
pp. 223-228 ◽  
Author(s):  
Hector E. James ◽  
John S. Bradley
Keyword(s):  
Antibiotic Therapy ◽  
Treatment Protocol ◽  
Shunt Infection ◽  
The Body ◽  
Clinical Report ◽  
Intravenous Antibiotic ◽  
Once Daily ◽  
Intravenous Antibiotic Therapy ◽  
Shunt Infections

Object The authors present their experience with a protocol for the treatment of patients with complicated shunt infections. Methods Complicated shunt infections are defined for the purpose of this protocol as multiple compartment hydrocephalus, multiple organism shunt infection, severe peritonitis, or infections in other sites of the body. The initial treatment protocol for these patients was 3 weeks of intravenous antibiotic therapy and 2 weeks of twice daily intraventricular/intrashunt antibiotic therapy. Cerebrospinal fluid (CSF) cultures were monitored during therapy and obtained again 48 hours after completion. The shunt was completely replaced. Additionally, follow-up cultures were obtained in all patients 3–6 months after therapy was completed. Results A cure of the infection was achieved in all patients as defined by negative cultures obtained at completion of antibiotic therapy and in follow-up studies. The follow-up period was 2–11 years (mean 4.4 ± 2.5 years). The treatment protocol was modified in the patients treated after 1991, and 18 patients were treated with this modified treatment regime. In these patients, intraventricular antibiotics were administered only once daily for 14 days, and the CSF was cultured 24 hours after antibiotic therapy had been stopped instead of after 48 hours. The results were similar to those obtained with the initial protocol. Conclusions Based on their prospective nonrandomized series, the authors believe that patients with complicated shunt infections can be successfully treated with 2 weeks of intraventricular antibiotic therapy administered once daily, concurrent with 3 weeks of intravenous antibiotic therapy. This protocol reduces length of treatment and hospital stay, and avoids recurrence of infection.

scholarly journals Effectiveness of early switching from intravenous to oral antibiotic therapy in Staphylococcus aureus prosthetic bone and joint or orthopedic metalware-associated infections

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hélène Boclé ◽  
Jean-Philippe Lavigne ◽  
Nicolas Cellier ◽  
Julien Crouzet ◽  
Pascal Kouyoumdjian ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Therapy ◽  
Treatment Failure ◽  
Cox Model ◽  
University Hospital ◽  
Empiric Antibiotic Therapy ◽  
Oral Antibiotic ◽  
Intravenous Antibiotic ◽  
Oral Antibiotic Therapy ◽  
Intravenous Antibiotic Therapy

Abstract Background The optimal duration of intravenous antibiotic therapy in Staphylococcus aureus prosthetic bone and joint infection has not been established. The objective of this study was to compare the effect of early and late intravenous-to-oral antibiotic switch on treatment failure. Patients and methods We retrospectively analyzed all adult cases of S. aureus prosthetic bone and joint or orthopedic metalware-associated infection between January 2008 and December 2015 in a French university hospital. The primary outcome was treatment failure defined as the recurrence of S. aureus prosthetic bone and joint or orthopedic metalware-associated infection at any time during or after the first line of medical and surgical treatment within 2 years of follow-up. A Cox model was created to assess risk factors for treatment failure. Results Among the 140 patients included, mean age was 60.4 years (SD 20.2), and 66% were male (n = 92). Most infections were due to methicillin-susceptible S. aureus (n = 113, 81%). The mean duration of intravenous antibiotic treatment was 4.1 days (SD 4.6). The majority of patients (119, 85%) had ≤5 days of intravenous therapy. Twelve patients (8.5%) experienced treatment failure. Methicillin-resistant S. aureus infections (HR 11.1; 95% CI 1.5–111.1; p = 0.02), obesity (BMI > 30 kg/m2) (HR 6.9; 95% CI1.4–34.4, p = 0.02) and non-conventional empiric antibiotic therapy (HR 7.1; 95% CI 1.8–25.2; p = 0.005) were significantly associated with treatment failure, whereas duration of intravenous antibiotic therapy (≤ 5 or > 5 days) was not. Conclusion There was a low treatment failure rate in patients with S. aureus prosthetic bone and joint or orthopedic metalware-associated infection with early oral switch from intravenous to oral antibiotic therapy.

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