Table 5.
Statistical predictors of initial antibiotic treatment failure – univariate and multivariate analyses
| Potential risk factors | Univariate analysis | Multivariate analysis | ||
|---|---|---|---|---|
| OR (95% CI) | P-value | OR (95% CI) | P-value | |
| Age, years | ||||
| 18–44a | Reference | 0.050b | – | – |
| 45–64 | 1.42 (0.70, 2.89) | – | – | |
| ≥65 | 2.14 (1.07, 4.26) | – | – | |
| Gender | ||||
| Femalea | Reference | 0.785 | ||
| Male | 0.94 (0.61, 1.45) | |||
| Country | ||||
| Spaina | Reference | 0.093b | – | – |
| Brazil | 2.17 (1.12, 4.22) | – | – | |
| France | 1.08 (0.55, 2.09) | – | – | |
| Italy | 0.95 (0.50, 1.83) | – | – | |
| Russia | 1.49 (0.77, 2.89) | – | – | |
| Number of days in hospital before the start of IAT | ||||
| 0.7a | Reference | 0.393 | – | – |
| 8–14 | 0.67 (0.35, 1.28) | – | – | |
| 15–30 | 0.69 (0.31, 1.51) | – | – | |
| >30 | 0.50 (0.15, 1.69) | – | – | |
| ICU admission (initial admission or transfer) | ||||
| Noa | Reference | <0.001b | Reference | – |
| Yes | 2.31 (1.48, 3.59) | 2.49 (1.13, 5.51) | 0.024 | |
| DCCS | ||||
| 0a | Reference | 0.080b | – | – |
| 1–2 | 1.16 (0.68, 1.96) | – | – | |
| 3–4 | 2.10 (1.08, 4.06) | – | – | |
| ≥5 | 1.77 (0.92, 3.42) | – | – | |
| Site-level resistance to third-generation cephalosporinsc | ||||
| Noa | Reference | 0.132b | – | – |
| Yes | 0.99 (0.98, 1.00) | – | – | |
| Site-level resistance to third-generation carbapenemsc | ||||
| Noa | Reference | 0.032b | – | – |
| Yes | 0.99 (0.98, 1.00) | – | – | |
| Combined site-level resistance to third-generation cephalosporins and carbapenemsc | ||||
| Noa | Reference | 0.001b | – | – |
| Yes | 0.98 (0.96, 0.99) | – | – | |
| Patient-level presence of MDR pathogen | ||||
| Noa | Reference | <0.001b | Reference | – |
| Yes | 2.58 (1.46, 4.58) | 5.45 (2.05, 14.52) | <0.001 | |
| Hospitalized within 90 days prior to the index hospitalization | ||||
| Noa | Reference | 0.019b | – | – |
| Yes | 1.78 (1.09, 2.91) | – | – | |
| Treated with β-lactam antibiotic within the past 3 months | ||||
| Noa | Reference | 0.008b | Reference | – |
| Yes | 2.03 (1.18, 3.52) | 3.20 (1.15, 8.87) | 0.025 | |
Notes: In this analysis, treatment outcome is either failure or success/indeterminate. The logistic regression coding is: 1= failure, 0= success or indeterminate.
Reference category.
Variables identified as significant in the univariate logistic regression analysis (P≤0.25) were analyzed by multivariate logistic regression analysis. Data shown are from the final model using the stepwise backward selection process; therefore, only significant data that remained in the final model for the multivariate analysis are shown.
On-site level of antibiotic resistance of Gram-negative isolates to third-generation cephalosporins, carbapenems or both combined.
Abbreviations: DCCS, Deyo-Charlson comorbidity score; IAT, initial antibiotic treatment; ICU, intensive care unit; MDR, multidrug resistant.