Accuracy of antibiotics use in patients with severe sepsis or septic shock in the Emergency Department

Authors

  • Seesuwan N Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai
  • Wittayachamnankul B Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai
  • Chenthanakij B Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai

Keywords:

sepsis, antibiotics, Emergency Department

Abstract

Objectives The purpose of this study was to evaluate the efficacy of antibiotics used by emergency physicians for treatment of pathogenic bacteria in severe sepsis and septic shock patients and to investigate the impact of antibiotic use on mortality and length of hospital stay of patients.

Methods A retrospective review of data of patients who had been diagnosed either severe sepsis and or septic shock in the Emergency Department (ED) of Maharaj Nakorn Chiang Mai Hospital from June 2011 through May 2012. Data on emergency physician decisions regarding use of antibiotics and the results of blood culture and sensitivity to antibiotic were recorded.

Results One-hundred and thirty-six patients were eligible for this study, of whom 33 (24.26%) were severe sepsis cases and 103 (75.74%) were septic shock cases. Antibiotics coverage was 80.9% for the severe sepsis patients and 82.9% for the septic shock patients. In the severe sepsis cases, the mortality rate among patients receiving antibiotics was lower than those who did not receive coverage antibiotics (20% vs. 25%, respectively, p = 0.048). In the patients with septic shock, mortality in the group receiving antibiotics was less than in the group that did not receive antibiotics (28.3% vs. 30.0%, respectively, p = 0.012). In both groups, there was no difference in the duration of hospital stay between patients who received proper antibiotic coverage and those who did not 14.5 days, [interquartile range (IQR) 3-19 days] vs. 14.3 days [IQR 4-26 days], respectively (p = 0.974) for the severe sepsis group and 18.2 days [IQR 5-28 days] vs. 11.1 days [IQR 4-17 days] (p = 0.287) for the septic shock patients.

Conclusions Four out of five patients with severe sepsis or septic shock who arrived in the emergency department received the appropriate antibiotic selected by the emergency physicians. Administration of appropriate antibiotics can potentially reduce mortality.

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Published

2021-10-01

How to Cite

1.
N S, B W, B C. Accuracy of antibiotics use in patients with severe sepsis or septic shock in the Emergency Department. Chiang Mai Med J. [Internet]. 2021 Oct. 1 [cited 2022 May 25];60(4):499-50. Available from: https://he01.tci-thaijo.org/index.php/CMMJ-MedCMJ/article/view/253932

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Original Article