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Article

Is Antimicrobial Dosing Adjustment Associated with Better Outcomes in Patients with Severe Obesity and Bloodstream Infections? An Exploratory Study

1
Department of Microbiology and Infectious Diseases, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
2
Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
3
Department of Pharmacy, Centre Intégré Universitaire de Santé et de Services Sociaux de l’Estrie-Centre Hospitalier Universitaire de Sherbrooke, Granby, QC J2G 1T7, Canada
*
Author to whom correspondence should be addressed.
Received: 8 September 2020 / Revised: 13 October 2020 / Accepted: 14 October 2020 / Published: 16 October 2020
(This article belongs to the Special Issue Antimicrobial Prescribing and Stewardship, 1st Volume)
The impact of adjusted treatment on clinical outcomes in patients with severe obesity is unclear. This study included adults with severe obesity admitted for bloodstream infections between 2005 and 2015. The patients were grouped according to the percentage of the appropriateness of the dosage of their antimicrobial treatment: 80–100% = good, 20–79% = moderate, and 0–19% = poor. The association between antimicrobial adjustment and a composite of unfavourable outcomes [intensive care unit stay ≥72 h, duration of sepsis >3 days, length of stay ≥7 days or all-cause 30-day mortality] was assessed using logistic regression. Of 110 included episodes, the adjustment was rated good in 47 (43%) episodes, moderate in 31 (28%), and poor in 32 (29%). Older age, Pitt bacteremia score ≥2, sepsis on day 1, and infection site were independent risk factors for unfavourable outcomes. The level of appropriateness was not associated with unfavourable outcomes. The number of antimicrobials, consultation with an infectious disease specialist, blood urea nitrogen 7–10.9 mmol/L, and hemodialysis were significantly associated with adjusted antimicrobial dosing. While the severity of the infection had a substantial impact on the measured outcomes, we did not find an association between dosing optimization and better outcomes. View Full-Text
Keywords: obesity; bloodstream infection; antimicrobials; prescription obesity; bloodstream infection; antimicrobials; prescription
MDPI and ACS Style

Sirard, S.; Abou Chakra, C.N.; Langlois, M.-F.; Perron, J.; Carignan, A.; Valiquette, L. Is Antimicrobial Dosing Adjustment Associated with Better Outcomes in Patients with Severe Obesity and Bloodstream Infections? An Exploratory Study. Antibiotics 2020, 9, 707. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9100707

AMA Style

Sirard S, Abou Chakra CN, Langlois M-F, Perron J, Carignan A, Valiquette L. Is Antimicrobial Dosing Adjustment Associated with Better Outcomes in Patients with Severe Obesity and Bloodstream Infections? An Exploratory Study. Antibiotics. 2020; 9(10):707. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9100707

Chicago/Turabian Style

Sirard, Stéphanie, Claire N. Abou Chakra, Marie-France Langlois, Julie Perron, Alex Carignan, and Louis Valiquette. 2020. "Is Antimicrobial Dosing Adjustment Associated with Better Outcomes in Patients with Severe Obesity and Bloodstream Infections? An Exploratory Study" Antibiotics 9, no. 10: 707. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9100707

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