Table 3.
Initial antimicrobial therapy according to appropriateness of therapy within 24 ha
| Initial therapyc | No. (%) of patients in group |
||
|---|---|---|---|
| All patients (n = 232) | Therapy within 24 h that was deemed: |
||
| Appropriate (n = 85; 37%) | Inappropriate (n = 147; 63%) | ||
| Monotherapy | |||
| Amoxicillin | 1 (0) | 0 (0) | 1 (1) |
| BLBLIC | 24 (10) | 0 (0) | 24 (16) |
| 2GC | 14 (6) | 0 (0) | 14 (10) |
| 3GC | 29 (13) | 0 (0) | 29 (20) |
| Aminoglycoside | 3 (1) | 1 (1) | 2 (1) |
| Fluoroquinolone | 7 (3) | 2 (2)b | 5 (3) |
| Cotrimoxazole | 2 (1) | 0 (0) | 2 (1) |
| Carbapenem | 62 (27) | 57 (67) | 5 (3) |
| Combination therapy | |||
| Amoxicillin + aminoglycoside | 5 (2) | 2 (2) | 3 (2) |
| Amoxicillin + fluoroquinolone | 4 (2) | 0 (0) | 4 (3) |
| BLBLIC + aminoglycoside | 12 (5) | 4 (5) | 8 (5) |
| BLBLIC + fluoroquinolone | 2 (1) | 1 (1)b | 1 (1) |
| 1GC + aminoglycoside | 1 (0) | 0 (0) | 1 (1) |
| 2GC + aminoglycoside | 16 (7) | 9 (11) | 7 (5) |
| 2GC + fluoroquinolone | 1 (0) | 1 (1)b | 0 (0) |
| 3GC + aminoglycoside | 6 (3) | 3 (4) | 3 (2) |
| 3GC + fluoroquinolone | 3 (1) | 0 (0) | 3 (2) |
| β-Lactam + cotrimoxazole | 3 (1) | 0 (0) | 3 (2) |
| Aminoglycoside + fluoroquinolone | 1 (0) | 0 (0) | 1 (1) |
| Cotrimoxazole + aminoglycoside + fluoroquinolone | 1 (0) | 1 (1) | 0 (0) |
| β-Lactam + aminoglycoside + fluoroquinolone | 7 (3) | 4 (5) | 3 (2) |
| No antimicrobial therapy | 5 (2) | 0 (0) | 5 (3) |
| Therapy started after 24 h | 23 (10) | 0 (0) | 23 (16) |
a
Appropriateness of therapy was judged according to in vitro susceptibility, duration of therapy, and, for oral fluoroquinolones or cotrimoxazole, severity of sepsis (see description in Materials and Methods).
b
In 3 instances, oral therapy with fluoroquinolones was deemed appropriate: once as monotherapy, once combined with an intravenous BLBLIC, and once combined with an intravenous second-generation cephalosporin.
c
1GC, first-generation cephalosporin; 2GC, second-generation cephalosporin; 3GC, third-generation cephalosporin; BLBLIC, β-lactam–β-lactamase inhibitor combination.