Table 4: Association of Target Attainment in Early Sepsis and in Late Sepsis with Hospitalization Characteristics and Outcomes.
Target defined as Concentrations above 1x Clinical Laboratory Standards Institute (CLSI) breakpoint/MIC for 100% dosing interval.
| Early Sepsis Target Attainment | Late Sepsis Target Attainment | ||||||
|---|---|---|---|---|---|---|---|
| Overall Cohort n=55 |
Did not Attain Target n=2 |
Attained Target n=53 |
p-value | Did not Attain Target n=10 |
Attained Target n=45 |
p-value | |
| Number of Patients for whom Q24h dosing initiated in Early Sepsis | 6 (10.9%) | 2 (100%) | 4 (7.5%) | 0.010 | 4 (40%) | 2 (4.4%) | 0.0076 |
| Number of Patients who had Q24h dosing in Late Sepsis (initiated or continued from Early Sepsis) | 15 (27.3%) | 2 (100%) | 13 (24.5%) | 0.071 | 10 (100%) | 5 (11.1%) | <0.001 |
| Number of Patients with Each Dosing Regimen in Phase of Interest | |||||||
| Q24h | -- | 2 (100%) | 4 (7.5%) | 0.010 | 10 (100%) | 5 (11.1%) | <0.001 |
| Q12h | 0 (0%) | 49 (92.5%) | 0 (0%) | 40 (89%) | |||
| Age (years) Median (IQR) | 7.5 (1.5, 13.8) | 4.1 (3.6, 4.7) | 8.2 (1.5, 13.8) | 0.64 | 2.2 (1.5, 4.7) | 8.2 (1.7, 13.8) | 0.33 |
| PRISM III Score Median (IQR) | 3.0 (0.5, 6.5) | 1.0 (0.5, 1.5) | 3.0 (1.0, 7.0) | 0.18 | 2.0 (0, 5.3) | 3.0 (2.0, 7.0) | 0.34 |
| PICU LOS (days) Median (IQR) | 4.0 (2.0, 7.5) | 2.5 (1.8, 3.3) | 4.0 (2.0, 8.0) | 0.24 | 2.0 (1.3, 3.5) | 5.0 (3.0, 8.0) | 0.0067 |
| Hospital LOS (days) Median (IQR) | 13.0 (8.0, 24.0) | 14.0 (12.5, 15.5) | 13.0 (8.0, 26.0) | 0.87 | 19.5 (8.8, 26.8) | 12.0 (8.0, 18.0) | 0.51 |
| Days on Vasopressor in PICU Median (IQR) | 1.0 (1.0, 2.0) | N/A (0 on pressors) | 1.0 (1.0, 2.0) | -- | 1.0 (1.0, 1.0) | 1.0 (1.0, 2.0) | 0.72 |
| Vasopressor-Free Days in PICU Median (IQR) | 4.0 (2.0, 7.5) | 2.5 (1.8, 3.3) | 4.0 (2.0, 8.0) | 0.31 | 2.0 (1.0, 3.5) | 5.0 (2.0, 8.0) | 0.015 |
| Days on Ventilator in Hospital | 5.0 (3.0, 13.0) | N/A (0 on ventilator) | 5.0 (3.0, 13.0) | -- | 1.0 (1.0, 7.0) | 5.5 (3.0, 15.8) | 0.22 |
| Ventilator-Free Days in PICU Median (IQR) | 2.0 (1.0. 2.5) | 2.5 (1.8, 3.3) | 2.0 (1.0, 2.0) | 0.58 | 1.5 (1.0, 2.0) | 2.0 (1.0, 3.0) | 0.58 |
| Sepsis Type | |||||||
| Culture-negative | 40 (73%) | 2 (100%) | 38 (72%) | 1 | 7 (70%) | 33 (73%) | 1 |
| Culture-positive | 15 (27%) | 0 (0%) | 15 (28%) | 3 (30%) | 12 (27%) | ||
| Presence of Comorbidities | |||||||
| No | 18 (33%) | 1 (50%) | 17 (32%) | 1 | 2 (20%) | 16 (36%) | 0.47 |
| Yes | 37 (67%) | 1 (50%) | 36 (68%) | 8 (80%) | 29 (64%) | ||
| Complicated Sepsis | |||||||
| No | 52 (94.5%) | 2 (100%) | 50 (94.3%) | 1 | 10 (100%) | 42 (93%) | 1 |
| Yes | 3 (5.5%) | 0 (0%) | 3 (5.7%) | 0 (0%) | 3 (7%) | ||
| Acute Kidney Injury in Early Sepsis | |||||||
| No | 33 (60%) | 2 (100%) | 31 (59%) | 0.51 | 7 (70%) | 26 (58%) | 0.72 |
| Yes | 22 (40%) | 0 (0%) | 22 (41%) | 3 (30%) | 19 (42%) | ||
| Acute Kidney Injury in Late Sepsis | |||||||
| No | 40 (73%) | 2 (100%) | 38 (72%) | 1 | 8 (80%) | 32 (71%) | 0.71 |
| Yes | 15 (27%) | 0 (0%) | 15 (285) | 2 (20%) | 13 (29%) | ||
| Total Parental Nutrition Use | |||||||
| No | 50 (91%) | 2 (100%) | 13 (25%) | 0.071 | 7 (70%) | 43 (96%) | 0.037 |
| Yes | 5 (9%) | 0 (0%) | 40 (75%) | 3 (30%) | 2 (4%) | ||
| Days on Ceftriaxone Median (IQR) | 7.0 (4.0, 8.0) | 8.0 (6.5, 9.5) | 7.0 (4.0, 8.0) | 0.51 | 7.0 (5.0, 9.3) | 6.0 (4.0, 8.0) | 0.72 |
| Broaden Antibiotics | |||||||
| No | 45 (82%) | 1 (50%) | 44 (83%) | 0.33 | 5 (50%) | 40 (89%) | 0.012 |
| Yes | 10 (18%) | 1 (50%) | 9 (17%) | 5 (50%) | 5 (11%) | ||
| Fever Duration (days) Median (IQR) | 2.0 (1.0, 3.0) | 4.5 (3.8, 5.3) | 2.0 (1.0, 3.0) | 0.11 | 2.5 (2.0, 3.8) | 2.0 (1.0, 3.0) | 0.068 |
| Number of Repeat Cultures in 7 days Median (IQR) | 1.0 (0.0, 6.0) | 2.0 (1.0, 3.0) | 1.0 (0.0, 2.0) | 0.68 | 2.0 (1.0, 2.0) | 0.0 (0.0, 2.0) | 0.087 |
| Number of CRP in 7 days Median (IQR) | 0.0 (0.0, 1.0) | 3.5 (1.8, 5.3) | 0.0 (0.0, 1.0) | 0.39 | 0.0 (0.0, 1.0) | 0.0 (0.0, 1.0) | 0.72 |
| Number of Procalcitonin 7 days Median (IQR) | 1.0 (0.0, 1.0) | 0.0 (0.0, 0.0) | 0.0 (0.0, 1.0) | 0.076 | 0.5 (0.0, 1.0) | 1.0 (0.0, 1.0) | 0.21 |