Inadequate Empiric Antibiotic Therapy among Canadian Hospitalized Solid-Organ Transplant Patients: Incidence and Impact on Hospital Mortality

• Main Author: Hamandi, Bassem
• Other Authors: Holbrook, Anne
• Format: Others
• Language: en_ca
• Published: 2008
• Subjects: Antibiotics; Infection; Solid Organ Transplantation; 0564
• Online Access: http://hdl.handle.net/1807/10433

Background: The incidence of inadequate empiric antibiotic therapy (IET) and its clinical importance as a risk factor for hospital mortality in Canadian solid-organ transplant patients remains unknown. Methods: This retrospective cohort study evaluated all patients admitted to a transplant unit from May/2002-April/2004. Therapy was considered adequate when the organism cultured was found to be susceptible to an antibiotic administered within 24 hours of the index sample collection time. Univariate and multivariate regression analyses were conducted to determine associations between potential determinants, IET, and mortality. Results: IET was administered in 169/312 (54%) transplant patients. Regression analysis demonstrated that an increasing duration of IET (adjusted OR at 24h, 1.33; p < 0.001), ICU-associated infections (adjusted OR, 6.27; p < 0.001), prior antibiotic use (adjusted OR, 3.56; p = 0.004), and increasing APACHE-II scores (adjusted OR, 1.26; p < 0.001), were independent determinants of hospital mortality. Conclusions: IET is common and appears to be an important determinant of hospital mortality in the Canadian transplant population.