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Article

Predictors of Appropriate Antibiotic Use in Bacteremia Patients Presenting at the Emergency Department

1
Department of Emergency Medicine, Faculty of Medicine, Khon-Kaen University, Khon Kaen 40002, Thailand
2
Sleep Apnea Research Group, Research Center in Back, Neck and Other Joint Pain and Human Performance, Research and Training Center for Enhancing Quality of Life of Working Age People, and Research and Diagnostic Center for Emerging Infectious Diseases (RCEID), Khon Kaen University, Khon Kaen 40002, Thailand
3
Clinical Microbiology Laboratory, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
4
Department of Medicine, Faculty of Medicine, Khon-Kaen University, Khon Kaen 40002, Thailand
*
Author to whom correspondence should be addressed.
Received: 7 August 2019 / Revised: 29 August 2019 / Accepted: 6 September 2019 / Published: 9 September 2019
(This article belongs to the Special Issue Sepsis: Pathophysiology, Diagnosis and Therapy)
Sepsis is a condition that requires appropriate antibiotic treatment at the emergency department (ED). Most previous studies conducted on inappropriate antibiotic use at the ED were conducted in developed countries with a low percentage of sepsis. This study aimed to find additional clinical predictors for appropriate antibiotic use in bacteremia patients presenting at the ED from a developing country, in which there is a higher proportion of patients with sepsis. We included adult patients who presented at the ED with clinical suspicion of infection and bacteremia. Patients allocated to the appropriate antibiotic group were those in whom the prescribed antibiotic was sensitive to the pathogen. Predictors and outcomes of appropriate antibiotic use were analyzed. A total of 3133 patients who met the study criteria presented at the ED during the study period. Of those, 271 patients were diagnosed with bacteremia, 48 of whom (17.71%) received inappropriate antibiotic prescriptions. Only pulse rate was an independent factor for appropriate antibiotic treatment, with an adjusted odds ratio of 1.019 (95% CI of 1.001, 1.036). In terms of clinical outcomes, the inappropriate antibiotic group had higher proportions of 28-day mortality (29.17% vs. 25.25%; p-value = 0.022) and longer hospitalization (14 vs. 9 days; p-value = 0.003). This study found that inappropriate antibiotics were prescribed in 17% of bacteremia patients presenting at the ED and that high pulse rate was an indicator for appropriate antibiotic prescription. Patients with inappropriate antibiotic administration had longer hospitalization and higher 28-day mortality than those who received appropriate antibiotic treatment. View Full-Text
Keywords: sepsis; pulse rate; predictors; mortality; hospitalization; community-acquired infection sepsis; pulse rate; predictors; mortality; hospitalization; community-acquired infection
MDPI and ACS Style

Phungoen, P.; Kraisriwattana, A.; Apiratwarakul, K.; Wonglakorn, L.; Sawanyawisuth, K. Predictors of Appropriate Antibiotic Use in Bacteremia Patients Presenting at the Emergency Department. Antibiotics 2019, 8, 142. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics8030142

AMA Style

Phungoen P, Kraisriwattana A, Apiratwarakul K, Wonglakorn L, Sawanyawisuth K. Predictors of Appropriate Antibiotic Use in Bacteremia Patients Presenting at the Emergency Department. Antibiotics. 2019; 8(3):142. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics8030142

Chicago/Turabian Style

Phungoen, Pariwat; Kraisriwattana, Areerat; Apiratwarakul, Korakot; Wonglakorn, Lumyai; Sawanyawisuth, Kittisak. 2019. "Predictors of Appropriate Antibiotic Use in Bacteremia Patients Presenting at the Emergency Department" Antibiotics 8, no. 3: 142. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics8030142

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