TABLE 3.
Clinical characteristics of patients receiving and not receiving aminoglycosides as empirical therapy
| Characteristica | No. (%; n = 4,863) | No. (%) receiving: |
OR (95% CI) | P | |
|---|---|---|---|---|---|
| Combination therapy (n = 678) | β-Lactam only (n = 4,185) | ||||
| Study period | |||||
| 1997-1999 | 1,018 | 234 (35) | 784 (19) | 1 | |
| 2000-2002 | 1,184 | 144 (21) | 1,040 (25) | 0.5 (0.4-0.6) | |
| 2003-2005 | 1,307 | 136 (20) | 1,171 (29) | 0.4 (0.3-0.5) | |
| 2006-2008 | 1,354 | 164 (24) | 1,190 (28) | 0.5 (0.4-0.6) | <0.0001 |
| Age >65 yr | 2,771 (57) | 300 (44) | 2,471 (59) | 0.6 (0.5-0.7) | <0.0001 |
| Male gender | 2,464 (51) | 375 (55) | 2,089 (50) | 1.2 (1.1-1.5) | 0.01 |
| Place of acquisition | |||||
| Community | 2,973 | 191 (28) | 2,782 (67) | 1 | |
| Hospital | 1,358 | 306 (45) | 1,052 (25) | 4.2 (3.5-5) | |
| Health care related | 532 | 181 (27) | 351 (8) | 7.5 (6-9) | <0.0001 |
| Ultimately/finally fatal underlying disease | 1,991 (41) | 421 (62) | 1,570 (38) | 3 (2-3.2) | <0.0001 |
| Hematological cancer | 609 (13) | 261 (39) | 348 (8) | 7 (6-8) | <0.0001 |
| Solid organ cancer | 992 (20) | 144 (21) | 848 (20) | 1 (0.9-1.3) | 0.6 |
| BMT | 103 (2) | 48 (7) | 55 (1) | 6 (4-9) | <0.0001 |
| Solid-organ transplant | 312 (6) | 21 (3) | 291 (7) | 0.4 (0.3-0.7) | 0.0001 |
| Neutropenia | 374 (8) | 190 (28) | 184 (4) | 9 (7-11) | <0.0001 |
| Heart failure | 546 (11) | 58 (9) | 488 (12) | 0.7 (0.5-0.95) | 0.02 |
| COPD | 358 (7) | 49 (7) | 309 (7) | 1 (0.7-1.3) | 0.9 |
| Renal insufficiency | 324 (7) | 47 (7) | 227 (7) | 1 (0.8-1.5) | 0.8 |
| Diabetes mellitus | 916 (19) | 82 (12) | 834 (20) | 0.6 (0.4-0.7) | <0.0001 |
| Cirrhosis | 490 (10) | 22 (3) | 468 (11) | 0.3 (0.2-0.4) | <0.0001 |
| HIV infection | 169 (4) | 22 (3) | 147 (4) | 0.9 (0.6-2) | 0.7 |
| Prior corticosteroids | 870 (18) | 202 (30) | 468 (11) | 2.3 (1.9-2.7) | <0.0001 |
| Prior antibiotics | 1,807 (37) | 434 (64) | 1,373 (33) | 3.6 (3-4.3) | <0.0001 |
| Prior surgery | 539 (11) | 118 (17) | 421 (10) | 1.9 (1.5-2.3) | <0.0001 |
| Bladder catheter | 855 (18) | 191 (28) | 664 (16) | 2 (1.9-2.5) | <0.0001 |
| Shock on presentation | 694 (14) | 168 (25) | 664 (16) | 2.3 (1.9-2.8) | <0.0001 |
| Source of infection | |||||
| Unknown | 870 (18) | 219 (32) | 651 (16) | 1 | |
| Urinary tract | 2,235 (46) | 124 (18) | 2,111 (50) | 0.17 (0.1-0.2) | |
| i.v. catheter | 419 (9) | 128 (19) | 291 (7) | 1.3 (1.01-1.7) | |
| Pneumonia | 249 (5) | 82 (12) | 167 (4) | 1.5 (1.1-2) | |
| Intraabdominal | 276 (6) | 30 (4) | 246 (6) | 0.4 (0.2-0.5) | |
| Biliary tract | 551 (11) | 47 (7) | 504 (12) | 0.3 (0.02-0.4) | |
| Skin/soft tissues | 132 (3) | 29 (4) | 103 (3) | 0.8 (0.5-1.3) | |
| Other | 131 (3) | 19 (3) | 112 (3) | 0.5 (0.3-0.8) | <0.0001 |
| Inappropriate empirical therapy | 454 (9) | 57 (8) | 397 (9) | 1.1 (0.9-1.5) | 0.4 |
a
BMT, bone marrow transplantation; COPD, chronic obstructive pulmonary disease.