Evidence map›Paper›PMID 34079939›Full record

ArticleCritical care explorations2021

A Multicenter Observational Study Evaluating Outcomes Associated With Antibiotic Combination Versus Monotherapy in Patients With Septic Shock.

Gustav Torisson, Martin Bruun Madsen, Agnes Schmidt Davidsen, Anders Perner, Jeffrey Lipman, Joel Dulhunty, Fredrik Sjövall

Abstract read
In one paragraph

Article in Critical care explorations, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Gustav TorissonDepartment of Infectious Diseases, Skane University Hospital, Malmö, Sweden.
Martin Bruun MadsenDepartment of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Agnes Schmidt DavidsenDronning Ingrids Hospital, Nuuk, Greenland.
Anders PernerDepartment of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Jeffrey LipmanIntensive Care Services, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia.
Joel DulhuntyIntensive Care Services, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia.
Fredrik SjövallDepartment of Intensive Care and Anaesthesia, Skane University Hospital, Malmö, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo explore the association between antibiotic combination therapy and in-hospital mortality in patients with septic shock in two tertiary ICUs in different countries.

designRetrospective observational study.

settingICUs of two tertiary hospitals, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia, and Rigshospitalet, Copenhagen, Denmark. PATIENTS: Adult patients with antibiotic treatment greater than or equal to 72 hours and vasopressor therapy greater than or equal to 24 hours.

interventionCombination versus mono antibiotic therapy. MEASUREMENTS AND MAIN

resultsCombination antibiotic therapy was defined as receiving two or more antibiotics from different classes, started within 12 hours of each other and with an overlapping duration of greater than or equal to 12 hours. Bivariate and multiple logistic regression analysis were performed comparing combination antibiotic therapy versus antibiotic monotherapy on in-hospital mortality. The analysis was adjusted for age, gender, centre, Acute Physiology and Chronic Health Evaluation II score, and chronic health evaluation. In total, 1,667 patients were included with 953 (57%) receiving combination therapy. Patients given combination therapy were older (60 ± 16 vs 56 ± 18), more likely admitted to Rigshospitalet (58% vs 16%), and had a higher Acute Physiology and Chronic Health Evaluation II score (26 ± 8 vs 23 ± 8). Combination therapy was associated with an increased mortality in univariate analysis (odds ratio = 1.33; 95% CI, 1.07-1.66); however, there was no significant association in the adjusted analysis (odds ratio = 0.88; 95% CI, 0.68-1.15).

conclusionsIn this retrospective study, no association was found between use of combination therapy and in-hospital mortality. The large differences between centers probably reflect local traditions and lack of definitive evidence.

Indexed as

antibioticcombination therapycritical careintensive caresepsisseptic shock

Identifiers

PMID34079939
PMCPMC8162507

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.