2 research outputs found
Impact of empirical treatment in extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella spp. bacteremia. A multicentric cohort study
BACKGROUND:
The objective of this study is to analyze the factors that are associated with the adequacy of empirical antibiotic therapy and its impact in mortality in a large cohort of patients with extended-spectrum β-lactamase (ESBL)--producing Escherichia coli and Klebsiella spp. bacteremia.
METHODS:
Cases of ESBL producing Enterobacteriaceae (ESBL-E) bacteremia collected from 2003 through 2008 in 19 hospitals in Spain. Statistical analysis was performed using multivariate logistic regression.
RESULTS:
We analyzed 387 cases ESBL-E bloodstream infections. The main sources of bacteremia were urinary tract (55.3%), biliary tract (12.7%), intra-abdominal (8.8%) and unknown origin (9.6%). Among all the 387 episodes, E. coli was isolated from blood cultures in 343 and in 45.71% the ESBL-E was multidrug resistant. Empirical antibiotic treatment was adequate in 48.8% of the cases and the in hospital mortality was 20.9%. In a multivariate analysis adequacy was a risk factor for death [adjusted OR (95% CI): 0.39 (0.31-0.97); P = 0.04], but not in patients without severe sepsis or shock. The class of antibiotic used empirically was not associated with prognosis in adequately treated patients.
CONCLUSION:
ESBL-E bacteremia has a relatively high mortality that is partly related with a low adequacy of empirical antibiotic treatment. In selected subgroups the relevance of the adequacy of empirical therapy is limited
Plan gallego de hospitalización a domicilio. Estrategia HADO 2019-2023
Documento estratéxico que pretende potenciar e consolidar a hospitalización a domicilio como un modelo asistencial do Servizo Galego de Saúde e garantir o seu desenvolvemento nos próximos seis anos, establecendo criterios homoxéneos de atención coa finalidade de normalizar os modelos asistenciais, carteira de servizos e fluxos de traballo para asegurar una asistencia sanitaria de calidadeDocumento estratégico que pretende potenciar y consolidar la hospitalización a domicilio como un modelo asistencial del Servicio Gallego de Salud y garantizar su desarrollo en los próximos seis años, estableciendo criterios homogéneos de atención con la finalidad de normalizar los modelos asistenciales, cartera de servicios y flujos de trabajo para asegurar una asistencia sanitaria de calida