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http://hdl.handle.net/1942/34822
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DC Field | Value | Language |
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dc.contributor.author | D'ONOFRIO, Valentino | - |
dc.contributor.author | MAGERMAN, Koen | - |
dc.contributor.author | WAUMANS, Luc | - |
dc.contributor.author | van Halem, Karlijn | - |
dc.contributor.author | COX, Janneke | - |
dc.contributor.author | Cartuyvels, Reinoud | - |
dc.contributor.author | VAN DER HILST, Jeroen | - |
dc.contributor.author | MESSIAEN, Peter | - |
dc.contributor.author | GYSSENS, Inge | - |
dc.contributor.author | Meersman, Agnes | - |
dc.date.accessioned | 2021-09-08T15:05:36Z | - |
dc.date.available | 2021-09-08T15:05:36Z | - |
dc.date.issued | 2021 | - |
dc.date.submitted | 2021-09-02T10:16:36Z | - |
dc.identifier.citation | International journal of antimicrobial agents (Print), 58 (3) (Art N° 106379) | - |
dc.identifier.uri | http://hdl.handle.net/1942/34822 | - |
dc.description.abstract | Objectives: To perform an audit of empirical antibiotic therapy (EAT) of sepsis at the emergency de-partment and to analyse the impact of an antimicrobial stewardship (AMS) programme on process and patient outcomes. Patients and Methods: A prospective, single-centre cohort study including patients with sequential or-gan failure assessment (SOFA) score >= 2 from whom blood cultures were taken was conducted between February 2019 and April 2020. EAT was assessed using eight applicable inpatient quality indicators (IQIs) for responsible antibiotic use. Patient outcomes were hospital length-of-stay (LOS), ICU admission, ICU LOS, and in-hospital mortality. Results: The audit included 900 sepsis episodes in 803 patients. Full guideline adherence regarding choice and dosing was 45.9%; adherence regarding choice alone was 68.1%. EAT was active against all likely pathogens in 665/787 (84.5%) episodes. In the guideline non-adherent group, choice of EAT was inappro-priate in 122/251 (48.6%) episodes. Changes within 3 days occurred in 335/900 (37.2%) episodes. Treating physicians changed administration route more often, whereas microbiological/infectious disease (ID)/AMS consultant advice resulted in de-escalation and discontinuation ( P = 0.0 0 0). Guideline-adherent choice was associated with significantly shorter LOS (6 (4-11) vs. 8 (5-15) days). Full adherence was associated with significantly lower mortality (23 (6.4%) vs. 48 (11.3%)) and shorter LOS (6 (4-10) vs. 8 (5-14) days). Conclusion: Five global quality indicators of EAT were measurable in routine clinical practice. Full ad-herence to guidelines was only moderate. Adherence to guidelines was associated with better patient outcomes. (c) 2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/ ) | - |
dc.description.sponsorship | European Union European Commission [GA 634137]; foundation Limburg Sterk Merk (LSM); Hasselt University; Jessa Hospital; Ziekenhuis Oost-Limburg | - |
dc.language.iso | en | - |
dc.publisher | ELSEVIER | - |
dc.rights | © 2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/) | - |
dc.subject.other | Empirical antibiotic therapy; guideline adherence; quality indicators; | - |
dc.subject.other | antimicrobial stewardship; antimicrobial mortality | - |
dc.title | Audit of empirical antibiotic therapy for sepsis and the impact of early multidisciplinary consultation on patient outcomes | - |
dc.type | Journal Contribution | - |
dc.identifier.issue | 3 | - |
dc.identifier.volume | 58 | - |
local.format.pages | 8 | - |
local.bibliographicCitation.jcat | A1 | - |
dc.description.notes | Gyssens, IC (corresponding author), Radboud Univ Nijmegen, Dept Internal Med, Med Ctr, Geert Grootepl Zuid 10, NL-6525 GA Nijmegen, Netherlands. | - |
dc.description.notes | inge.gyssens@radboudumc.nl | - |
local.publisher.place | RADARWEG 29, 1043 NX AMSTERDAM, NETHERLANDS | - |
local.type.refereed | Refereed | - |
local.type.specified | Article | - |
local.bibliographicCitation.artnr | 106379 | - |
dc.identifier.doi | 10.1016/j.ijantimicag.2021.106379 | - |
dc.identifier.isi | WOS:000684980600005 | - |
dc.contributor.orcid | D'Onofrio, Valentino/0000-0003-3828-0442; van der Hilst, | - |
dc.contributor.orcid | Jeroen/0000-0003-4527-6310; Gyssens, Inge/0000-0002-9226-0752; van | - |
dc.contributor.orcid | Halem, Karlijn/0000-0001-9483-8522 | - |
local.provider.type | wosris | - |
local.uhasselt.uhpub | yes | - |
local.description.affiliation | [D'Onofrio, Valentino; Cox, Janneke A.; van der Hilst, Jeroen C.; Messiaen, Peter; Gyssens, Inge C.] Hasselt Univ, Fac Med & Life Sci, Hasselt, Belgium. | - |
local.description.affiliation | [D'Onofrio, Valentino; van Halem, Karlijn; Cox, Janneke A.; van der Hilst, Jeroen C.; Messiaen, Peter] Jessa Hosp, Dept Infect Dis & Immun, Hasselt, Belgium. | - |
local.description.affiliation | [D'Onofrio, Valentino; Gyssens, Inge C.] Radboud Univ Nijmegen, Dept Internal Med, Med Ctr, Geert Grootepl Zuid 10, NL-6525 GA Nijmegen, Netherlands. | - |
local.description.affiliation | [D'Onofrio, Valentino; Gyssens, Inge C.] Radboud Univ Nijmegen, Radboud Ctr Infect Dis, Med Ctr, Nijmegen, Netherlands. | - |
local.description.affiliation | [Meersman, Agnes] Jessa Hosp, Emergency Dept, Hasselt, Belgium. | - |
local.description.affiliation | [Magerman, Koen; Waumans, Luc; Cartuyvels, Reinoud] Jessa Hosp, Dept Clin Biol, Hasselt, Belgium. | - |
local.uhasselt.international | yes | - |
item.accessRights | Open Access | - |
item.validation | ecoom 2022 | - |
item.fulltext | With Fulltext | - |
item.contributor | D'ONOFRIO, Valentino | - |
item.contributor | MAGERMAN, Koen | - |
item.contributor | WAUMANS, Luc | - |
item.contributor | van Halem, Karlijn | - |
item.contributor | COX, Janneke | - |
item.contributor | Cartuyvels, Reinoud | - |
item.contributor | VAN DER HILST, Jeroen | - |
item.contributor | MESSIAEN, Peter | - |
item.contributor | GYSSENS, Inge | - |
item.contributor | Meersman, Agnes | - |
item.fullcitation | D'ONOFRIO, Valentino; MAGERMAN, Koen; WAUMANS, Luc; van Halem, Karlijn; COX, Janneke; Cartuyvels, Reinoud; VAN DER HILST, Jeroen; MESSIAEN, Peter; GYSSENS, Inge & Meersman, Agnes (2021) Audit of empirical antibiotic therapy for sepsis and the impact of early multidisciplinary consultation on patient outcomes. In: International journal of antimicrobial agents (Print), 58 (3) (Art N° 106379). | - |
crisitem.journal.issn | 0924-8579 | - |
crisitem.journal.eissn | 1872-7913 | - |
Appears in Collections: | Research publications |
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1-s20-S0924857921001382-main.pdf | Published version | 451.09 kB | Adobe PDF | View/Open |
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