Table 3.
Empirical antimicrobial therapy for the characteristic patients with E. coli BSIa.
| Antimicrobial choice for empirical therapy | Total |
Early mortality |
Adequate treatment |
Critically illb |
ICU inpatients |
HO infection |
||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| n = 1473 | n = 141 | Pc | n = 1142 | Pc | n = 111 | Pc | n = 161 | Pc | n = 290 | Pc | ||
| Penicillins | Monotherapy | 31 (2·1%) | 4 (2.8%) | 0·531 | 8 (0.7%) | <0·001* | 5 (4.5%) | 0·078 | 14 (8.7%) | <0·001* | 14 (4.8%) | <0·001* |
| Combination therapy | 4 (0·3%) | 1 (0.7%) | 0·332 | 3 (0.3%) | 1·000 | 0 (0%) | 1·000 | 4 (2.5%) | <0·001* | 1 (0.3%) | 0·584 | |
| Penicillins/beta-lactamase inhibitors | Monotherapy | 161 (10·9%) | 22 (15.6%) | 0·066 | 147 (12.9%) | <0·001* | 19 (17.1%) | 0·039 | 25 (15.5%) | 0·060 | 5 (1.7%) | 0·528 |
| Combination therapy | 29 (2·0%) | 7 (5·0%) | 0·016 | 27 (2.4%) | 0·043 | 6 (5.4%) | 0·018 | 4 (2.5%) | 0·549 | 9 (3.1%) | 0·153 | |
| 1st-generation cephalosporins | Monotherapy | 7 (0·5%) | 0 (0%) | 1·000 | 6 (0.5%) | 1·000 | 0 (0%) | 1·000 | 1 (0.6%) | 0·556 | 4 (1.4%) | 0·031 |
| Combination therapy | 7 (0·5%) | 1 (0.7%) | 0·506 | 7 (0.6%) | 0·360 | 1 (0.9%) | 0·423 | 0 (0%) | 1·000 | 2 (0.7%) | 0·630 | |
| 3rd/4th-generation cephalosporins | Monotherapy | 747 (50·7%) | 49 (34.8%) | <0·001* | 572 (50.1%) | 0·383 | 38 (34.2%) | <0·001* | 68 (42.2%) | 0·024 | 116 (40·0%) | <0·001* |
| Combination therapy | 72 (4·9%) | 9 (6.4%) | 0·408 | 60 (5.3%) | 0·250 | 11 (9.9%) | 0·019 | 6 (3.7%) | 0·565 | 20 (6.9%) | 0·093 | |
| Carbapenems | Monotherapy | 165 (11·2%) | 25 (17.7%) | 0·016 | 165 (14.4%) | <0·001* | 25 (22.5%) | <0·001* | 22 (13.7%) | 0·290 | 39 (13.4%) | 0·178 |
| Combination therapy | 41 (2·8%) | 10 (7.1%) | 0·004 | 41 (3.6%) | <0·001* | 2 (1.8%) | 0·764 | 3 (1.9%) | 0·614 | 8 (2.8%) | >0·999 | |
| Fluoroquinolones | Monotherapy | 165 (11·2%) | 4 (2.8%) | <0·001* | 98 (8.6%) | <0·001* | 2 (1.8%) | <0·001* | 7 (4.3%) | <0·001* | 26 (9.0%) | 0·212 |
| Combination therapyd | 130 (8·8%) | 25 (17.7%) | <0·001* | 122 (10.7%) | <0·001* | 15 (13.5%) | 0·081 | 11 (6.8%) | 0·461 | 30 (10.3%) | 0·300 | |
| Otherse | 8 (0·5%) | 5 (3.5%) | <0·001* | 5 (0.4%) | 0·389 | 1 (0.9%) | 0·467 | 3 (1.9%) | 0·047 | 7 (2.4%) | <0·001* | |
| Not-for-Gram-negatives | 29 (2·0%) | 2 (1.4%) | – | 0 (0%) | – | 1 (0.9%) | – | 3 (1.9%) | – | 8 (2.8%) | – | |
| Refusal of antimicrobial therapy | 1 (0·1%) | 0 (0%) | – | 0 (0%) | – | 0 (0%) | – | 1 (0.6%) | – | 0 (0%) | – | |
ICU, intensive care unit; HO, hospital-origin.
a
Nineteen cases of the follow-up-loss before 2nd day of the treatment were excluded from the analysis. The percentage was calculated out of total number of E. coli BSI cases.
b
Critically ill patients were defined as those with SOFA score at ≥9.
c
P value is from Pearson's chi-square test. Bonferroni corrected significance level was considered as P < 0.003 and the significant P values are indicated with asterisks.
d
Combination fluoroqniolone therapy was always with beta-lactams.
e
Glycylcyclines (n = 4), rifampicin (n = 2), cephamycins (n = 1), and sulfonamides (n = 1) were included.