ArticleBMC infectious diseases2023
Effect of appropriate empirical antimicrobial therapy on mortality of patients with Gram-negative bloodstream infections: a retrospective cohort study.
Article in BMC infectious diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Female Sex and Mortality in Patients With Gram-Negative Bacteremia: A Systematic Review and Meta-Analysis.JAMA network open · 2025Pooled it
- Antimicrobial susceptibility concordance between colonising and bloodstream ESBL and carbapenemase-producing Enterobacterales in allogeneic stem cell transplant recipients: a 10-year retrospective cohort study.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2026Article
- Impact of appropriate antimicrobial therapy on patient outcomes and antimicrobial use: a sub analysis of the DIANA Study Dataset.Intensive care medicine · 2026Article
- Assessing appropriateness of antibiotic therapy: a scoping review of definitions and their clinical implication.Infection · 2026Article
- Diagnostic Performance and Prognostic Value of Serum Amyloid A in Patients with Bloodstream Infection.Diagnostics (Basel, Switzerland) · 2026Article
- Clinical evaluation of EUCAST rapid antimicrobial susceptibility testing in Gram-negative bacilli bloodstream infections: a real-world retrospective study.Frontiers in microbiology · 2026Article
- Etiological Agents of Bacteremia in Patients with Hematological Malignancies: Evaluation of 18 Years of Data.Infectious diseases & clinical microbiology · 2025Article
- Antimicrobial Stewardship Impact on Antibiotic Use in Three Tertiary Hospitals in Zambia: A Comparative Point Prevalence Survey.Antibiotics (Basel, Switzerland) · 2025Article
- Clinical and implementation outcomes of an antimicrobial stewardship intervention for rapid blood culture diagnostics.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Article
- Association Between Infectious Diseases Consultation and Mortality in Hospitalized Patients With Gram-negative Bloodstream Infection: A Retrospective Population-wide Cohort Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Epidemiology and clinical relevance of persistent bacteraemia in patients with Gram-negative bloodstream infection: a retrospective cohort study.The Journal of antimicrobial chemotherapy · 2024Article
- Prevalence of Antimicrobial Resistance in Gram-Negative Bacteria Bloodstream Infections in Peru and Associated Outcomes: VIRAPERU Study.The American journal of tropical medicine and hygiene · 2023Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLittle evidence exists regarding the prevalence of pathogens in bloodstream infections (BSIs), the mortality risk, and the benefit of combination therapy over monotherapy. This study aims to describe patterns of empiric antimicrobial therapy, and the epidemiology of Gram-negative pathogens, and to investigate the effect of appropriate therapy and appropriate combination therapy on the mortality of patients with BSIs.
methodsThis was a retrospective cohort study including all patients with BSIs of Gram-negative pathogens from January 2017 to December 2022 in a Chinese general hospital. The in-hospital mortality was compared between appropriate and inappropriate therapy, and between monotherapy and combination therapy for patients receiving appropriate therapy. We used Cox regression analysis to identify factors independently associated with in-hospital mortality.
resultsWe included 205 patients in the study, of whom 147 (71.71%) patients received appropriate therapy compared with 58 (28.29%) who received inappropriate therapy. The most common Gram-negative pathogen was Escherichia coli (37.56%). 131 (63.90%) patients received monotherapy and 74 (36.10%) patients received combination therapy. The in-hospital mortality was significantly lower in patients administered appropriate therapy than inappropriate therapy (16.33% vs. 48.28%, p = 0.004); adjusted hazard ratio [HR] 0.55 [95% CI 0.35-0.84], p = 0.006). In-hospital mortality was also not different in combination therapy and monotherapy in the multivariate Cox regression analyses (adjusted HR 0.42 [95% CI 0.15-1.17], p = 0.096). However, combination therapy was associated with lower mortality than monotherapy in patients with sepsis or septic shock (adjusted HR 0.94 [95% CI 0.86-1.02], p = 0.047).
conclusionsAppropriate therapy was associated with a protective effect on mortality among patients with BSIs due to Gram-negative pathogens. Combination therapy was associated with improved survival in patients with sepsis or septic shock. Clinicians need to choose optical empirical antimicrobials to improve survival outcomes in patients with BSIs.
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