Discontinuation of Glycopeptides in Patients with Culture Negative Severe Sepsis or Septic Shock: A Propensity-Matched Retrospective Cohort Study
Implementation of antibiotic stewardship is difficult in patients with sepsis because of severity of disease. We evaluated the impact of glycopeptide discontinuation (GD) in patients with culture negative severe sepsis or septic shock who received glycopeptides as initial empiric antibiotic therapy...
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| Format: | Article |
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MDPI AG
2020-05-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/9/5/250 |
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| author | Yong Chan Kim Jung Ho Kim Jin Young Ahn Su Jin Jeong Nam Su Ku Jun Yong Choi Joon-Sup Yeom Yoon Soo Park Young Goo Song Ha Yan Kim |
| author_facet | Yong Chan Kim Jung Ho Kim Jin Young Ahn Su Jin Jeong Nam Su Ku Jun Yong Choi Joon-Sup Yeom Yoon Soo Park Young Goo Song Ha Yan Kim |
| author_sort | Yong Chan Kim |
| collection | DOAJ |
| description | Implementation of antibiotic stewardship is difficult in patients with sepsis because of severity of disease. We evaluated the impact of glycopeptide discontinuation (GD) in patients with culture negative severe sepsis or septic shock who received glycopeptides as initial empiric antibiotic therapy at admission. We conducted a single center retrospective cohort study between January 2010 and March 2018. GD was defined as discontinuation of initial empiric glycopeptides on availability of culture results, revealing the absence of identified pathogens. In 92 included patients, the leading causes of sepsis were pneumonia (34.8%) and intra-abdominal infection (23.9%); 28-day mortality and overall mortality were 14% and 21%, respectively. Glycopeptides were discontinued in 42/92 patients. After propensity score matching, baseline characteristics were not significantly different between the GD and non-GD (GND) groups. GND was associated with development of acute kidney injury (OR 5.54, 95% CI 1.49–20.6, <i>P</i> = 0.011). GD did not increase the 7-day, 14-day, and 28-day mortality compared with GND. The length of hospital stay was shorter in the GD group than in GND group (16.33 ± 17.11 vs. 25.05 ± 14.37, <i>P</i> = 0.082), though not statistically significant. GD may be safe and reduce adverse events of prolonged antibiotic use in patients with culture negative severe sepsis or septic shock receiving glycopeptides as initial empiric antibiotic therapy. |
| first_indexed | 2024-03-10T19:51:09Z |
| format | Article |
| id | doaj.art-06287b7e86b745fe8b4fd375ec07bb41 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T19:51:09Z |
| publishDate | 2020-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-06287b7e86b745fe8b4fd375ec07bb412023-11-20T00:17:39ZengMDPI AGAntibiotics2079-63822020-05-019525010.3390/antibiotics9050250Discontinuation of Glycopeptides in Patients with Culture Negative Severe Sepsis or Septic Shock: A Propensity-Matched Retrospective Cohort StudyYong Chan Kim0Jung Ho Kim1Jin Young Ahn2Su Jin Jeong3Nam Su Ku4Jun Yong Choi5Joon-Sup Yeom6Yoon Soo Park7Young Goo Song8Ha Yan Kim9Department of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, KoreaBiostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul 03722, KoreaImplementation of antibiotic stewardship is difficult in patients with sepsis because of severity of disease. We evaluated the impact of glycopeptide discontinuation (GD) in patients with culture negative severe sepsis or septic shock who received glycopeptides as initial empiric antibiotic therapy at admission. We conducted a single center retrospective cohort study between January 2010 and March 2018. GD was defined as discontinuation of initial empiric glycopeptides on availability of culture results, revealing the absence of identified pathogens. In 92 included patients, the leading causes of sepsis were pneumonia (34.8%) and intra-abdominal infection (23.9%); 28-day mortality and overall mortality were 14% and 21%, respectively. Glycopeptides were discontinued in 42/92 patients. After propensity score matching, baseline characteristics were not significantly different between the GD and non-GD (GND) groups. GND was associated with development of acute kidney injury (OR 5.54, 95% CI 1.49–20.6, <i>P</i> = 0.011). GD did not increase the 7-day, 14-day, and 28-day mortality compared with GND. The length of hospital stay was shorter in the GD group than in GND group (16.33 ± 17.11 vs. 25.05 ± 14.37, <i>P</i> = 0.082), though not statistically significant. GD may be safe and reduce adverse events of prolonged antibiotic use in patients with culture negative severe sepsis or septic shock receiving glycopeptides as initial empiric antibiotic therapy.https://www.mdpi.com/2079-6382/9/5/250glycopeptidesantimicrobial stewardshipsepsisseptic shockpropensity score |
| spellingShingle | Yong Chan Kim Jung Ho Kim Jin Young Ahn Su Jin Jeong Nam Su Ku Jun Yong Choi Joon-Sup Yeom Yoon Soo Park Young Goo Song Ha Yan Kim Discontinuation of Glycopeptides in Patients with Culture Negative Severe Sepsis or Septic Shock: A Propensity-Matched Retrospective Cohort Study Antibiotics glycopeptides antimicrobial stewardship sepsis septic shock propensity score |
| title | Discontinuation of Glycopeptides in Patients with Culture Negative Severe Sepsis or Septic Shock: A Propensity-Matched Retrospective Cohort Study |
| title_full | Discontinuation of Glycopeptides in Patients with Culture Negative Severe Sepsis or Septic Shock: A Propensity-Matched Retrospective Cohort Study |
| title_fullStr | Discontinuation of Glycopeptides in Patients with Culture Negative Severe Sepsis or Septic Shock: A Propensity-Matched Retrospective Cohort Study |
| title_full_unstemmed | Discontinuation of Glycopeptides in Patients with Culture Negative Severe Sepsis or Septic Shock: A Propensity-Matched Retrospective Cohort Study |
| title_short | Discontinuation of Glycopeptides in Patients with Culture Negative Severe Sepsis or Septic Shock: A Propensity-Matched Retrospective Cohort Study |
| title_sort | discontinuation of glycopeptides in patients with culture negative severe sepsis or septic shock a propensity matched retrospective cohort study |
| topic | glycopeptides antimicrobial stewardship sepsis septic shock propensity score |
| url | https://www.mdpi.com/2079-6382/9/5/250 |
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