Table 1.
Demographic and clinical characteristics of the 206 patients with or without subsequent antibiotic de-escalation
| Characteristic | De-escalation (n = 110) | No de-escalation (n = 96) | Escalation (n = 65) | No change (n = 31) |
|---|---|---|---|---|
| Male sex, n (%) | 61 (55) | 56 (58) | 35 (54) | 21 (68) |
| Age, years, median (IQR) | 61 (47–72) | 66 (51–75)a | 63 (47–75) | 70 (58–77) |
| Comorbidities | ||||
| Fatal underlying disease | 30 (27) | 32 (33) | 21 (32) | 11 (35) |
| Cancer, n (%) | 37 (34) | 36 (38) | 23 (35) | 13 (42) |
| Diabetes, n (%) | 17 (15) | 15 (16) | 9 (14) | 6 (19) |
| Time since initial surgery, days, median (IQR) | 7 (5–12) | 7 (4–10) | 6 (3–9) | 8 (5–10) |
| Antibiotic therapy before reoperation, n (%) | 73 (66) | 68 (71) | 47 (72) | 21 (68) |
| Broad-spectrum interim antibiotic, n (%) | 34 (31) | 37 (39) | 27 (42) | 10 (32) |
| Intraoperative diagnosis | ||||
| Anastomotic leakage, n (%) | 45 (41) | 27 (28) | 19 (29) | 8 (26) |
| Perforation or ischemia, n (%) | 33 (30) | 36 (38) | 20 (31) | 16 (52)a# |
| Purulent collection, n (%) | 19 (17) | 17 (18) | 13 (20) | 4 (13) |
| No cause, n (%) | 19 (17) | 20 (21) | 15 (23) | 5 (16) |
| Contamination below transverse mesocolon, n (%) | 82 (75) | 74 (77) | 50 (77) | 24 (77) |
| Characteristics at the time of ICU admission | ||||
| Bacteremia, n (%) | 26 (24) | 17 (18) | 14 (22) | 3 (10) |
| SAPS II score, median (IQR) | 45 (34–54) | 47 (35–57) | 44 (34–56) | 51 (42–61)a# |
| SOFA score, median (IQR) | 7 (4–9) | 8 (4–10) | 7 (4–9) | 9 (6–10) |
| Hemodynamic failureb, n (%) | 65 (59) | 65 (68) | 41 (63) | 24 (77) |
| Respiratory failureb, n (%) | 54 (49) | 40 (42) | 26 (40) | 14 (45) |
| Renal failureb, n (%) | 21 (19) | 18 (19) | 13 (20) | 5 (16) |
IQR interquartile range, SAPS II Simplified Acute Physiology Score II, SOFA Sequential Organ Failure Assessment
Patients without de-escalation were also analyzed in terms of subsequent antibiotic escalation or no change. Results are expressed as number and proportions or median (IQR)
a p < 0.05 versus de-escalation
bSOFA score of 3 or 4 for each organ
# p < 0.05 versus escalation