Juri Katchanov, Benno Kreuels, Florian P. Maurer, Kai Wöstmann, Johannes Jochum, Christina König, Kariem Seoudy, Holger Rohde, Ansgar W. Lohse, Dominic Wichmann, Michael Baehr, Camilla Rothe, Stefan Kluge
Abstract
Inappropriate use of broad-spectrum antimicrobials affects adversely both the individual patient and the general public. The aim of the study was to identify patients at risk for excessively prolonged carbapenem treatment in the ICU as a target for antimicrobial stewardship interventions.
Case-control study in a network of 11 ICUs of a university hospital. Patients with uninterrupted meropenem therapy (MT) > 4 weeks were compared to controls. Controls were defined as patients who stayed on the ICU > 4 weeks and received meropenem for ≤ 2 weeks. Associations between case-control status and potential risk factors were determined in a multivariate logistic regression model.
Between 1(st) of January 2013 and 31(st) of December 2015, we identified 36 patients with uninterrupted MT > 4 weeks. Patients with prolonged MT were more likely to be surgical patients (72.2% of cases vs. 31.5% of controls; p ≤ 0.001) with peritonitis being the most common infection (n = 16, 44.4%). In the multivariate logistic regression model colonization with multidrug-resistant (MDR) Gram-negative bacteria (OR 7.52; 95% CI 1.88-30.14, p = 0.004) and the type of infection (peritonitis vs. pneumonia: OR 16.96, 95% CI 2.95-97.49) were associated with prolonged MT.
Surgical patients with peritonitis and patients with known colonization with MDR Gram-negative bacteria are at risk for excessively prolonged carbapenem therapy and represent an important target population for antimicrobial stewardship interventions.
Pharmacology, Toxicology and Pharmaceutical Science
2
4%
Biochemistry, Genetics and Molecular Biology
2
4%
Other
4
8%
Unknown
18
36%
Attention Score in Context
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 February 2017.
All research outputs
#13,022,980
of 22,953,506 outputs
Outputs from BMC Infectious Diseases
#3,040
of 7,704 outputs
Outputs of similar age
#199,314
of 420,410 outputs
Outputs of similar age from BMC Infectious Diseases
#94
of 169 outputs
Altmetric has tracked 22,953,506 research outputs across all sources so far. This one is in the 42nd percentile – i.e., 42% of other outputs scored the same or lower than it.
So far Altmetric has tracked 7,704 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.6. This one has gotten more attention than average, scoring higher than 59% of its peers.
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We're also able to compare this research output to 169 others from the same source and published within six weeks on either side of this one. This one is in the 43rd percentile – i.e., 43% of its contemporaries scored the same or lower than it.
