Table 2.
Characteristics of patients in the de-escalation group (intervention) and in the non-de-escalation group (control)
| Variables | All (n = 66) | De-escalation (n = 32) | Non-de-escalation (n = 34) | P-value |
|---|---|---|---|---|
| Baseline characteristics | ||||
| Mean age, years | 64.8 ± 19.6 | 67.5 ± 17.2 | 62.2 ± 21.6 | 0.28 |
| Female | 38 (57.6%) | 19 (59.4%) | 19 (55.9%) | 0.81 |
| Medicine ward | 58 (87.9%) | 26 (81.3%) | 32 (94.1%) | 0.11 |
| Underlying disease | ||||
| ● Hypertension | 37 (56.1%) | 19 (59.4%) | 18 (52.9%) | 0.60 |
| ● Cerebrovascular disease | 15 (22.7%) | 9 (28.1%) | 6 (17.7%) | 0.31 |
| ● Chronic lung disease | 10 (15.2%) | 2 (6.3%) | 8 (23.5%) | 0.08 |
| ● Cardiovascular disease | 22 (33.3%) | 11 (34.4%) | 11 (32.4%) | 0.86 |
| ● Diabetes mellitus | 25 (37.9%) | 11 (34.4%) | 14 (41.2%) | 0.57 |
| ● Chronic kidney disease | 23 (34.9%) | 12 (37.5%) | 11 (32.4%) | 0.66 |
| ● Chronic liver disease | 7 (10.6%) | 3 (9.4%) | 4 (11.8%) | 1.00 |
| ● Malignancy | 17 (26.6%) | 9 (28.1%) | 8 (23.5%) | 0.67 |
| ● Any immunocompromised conditiona | 16 (24.2%) | 7 (21.9%) | 9 (36.5%) | 0.66 |
| APACHE II score at enrollmentb | 12.4 ± 5.9 (n = 10) | 13.8 ± 8.2 (n = 5) | 11.0 ± 2.3 (n = 5) | 0.49 |
| Modified APACHE II score at enrollmentc | 8.9 ± 4.9 | 8.9 ± 5.1 | 8.9 ± 4.9 | 0.94 |
| ● History of organ insufficiency | 35 (53.9%) | 20 (62.5%) | 15 (45.5%) | 0.17 |
| ● Emergency surgery | 8 (12.1%) | 5 (15.6%) | 3 (8.8%) | 0.47 |
| ● Acute renal failure | 8 (12.1%) | 8 (25.0%) | 0 (0.0%) | 0.002 |
| ● ICU admission | 3 (4.6%) | 2 (6.3%) | 1 (2.9%) | 0.42 |
| Characteristics of infections | ||||
| Hospital-acquired infection | 32 (48.5%) | 12 (37.5%) | 20 (58.8%) | 0.08 |
| Site of infection at enrollment | 1.00 | |||
| ● Urinary tract infection | 27 (40.9%) | 13 (40.6%) | 14 (41.2%) | |
| ● Pneumonia | 11 (16.7%) | 5 (15.6%) | 6 (16.7%) | |
| ● Others | 29 (43.9%) | 14 (43.8%) | 15 (44.1%) | |
| ● Primary bacteremia | 26 (78.8%) | 14 (82.4%) | 12 (75.0%) | |
| ● Skin infection | 1 (1.5%) | 0 | 1 (2.9%) | |
| ● Reproductive tract infection | 1 (1.5%) | 0 | 1 (2.9%) | |
| ● Gastrointestinal tract infection | 1 (1.5%) | 0 | 1 (2.9%) | |
| Having bacteremia | 33 (50.0%) | 17 (53.1%) | 16 (47.1%) | 0.62 |
| Cause of bacteremiad | (n = 17) | (n = 16) | 0.57 | |
| ● Primary bacteremia | 26 (78.8%) | 14 (82.4%) | 12 (75.0%) | |
| ● Urinary tract infection | 5 (15.2%) | 3 (17.6%) | 2 (12.5%) | |
| ● Catheter-related infection | 2 (6.0%) | 0 | 2 (12.5%) | |
| Causative pathogene | ||||
| ● Escherichia coli | 46 (69.7%) | 24 (75.0%) | 22 (64.7%) | 0.36 |
| ● Klebsiella spp. | 21 (31.8%) | 8 (25.0%) | 13 (38.2%) | 0.25 |
| Mean time from onset of infection to enrollment, days | 4.3 ± 1.4 | 4.2 ± 1.6 | 4.5 ± 1.2 | 0.47 |
| Mean duration of pre-enrollment use of group 2 carbapenems, days | 2.8 ± 1.6 | 3.1 ± 1.5 | 2.6 ± 1.7 | 0.29 |
| Mean duration of pre-enrollment use of any antibiotics, days | 3.1 ± 5.8 | 3.3 ± 5.4 | 3.0 ± 6.3 | 0.82 |
aAny immunocompromised condition (e.g., HIV infection, receipt of immunosuppressive agents (steroid, cytotoxic agents, and/or chemotherapy))
bAPACHE II score was calculated using data from 10 patients with available arterial blood gas results
cModified APACHE II score was calculated in all patients. For those who did not have arterial blood gas results, the arterial pH was substituted by the level of serum bicarbonate
dAll patients with secondary bacteremia due to UTI (n = 5) were enrolled into the UTI stratum. Other cases of secondary bacteremia were due to cellulitis (n = 1) and spontaneous bacterial peritonitis (n = 1)
eOne patient in the group 2 carbapenems group had bacteremia caused by both Escherichia coli and Klebsiella spp
Abbreviation: APACHE II Acute Physiology and Chronic Health Evaluation II
Data are presented as n (%), mean ± SD; P-value < 0.05 indicates statistical significance