Discontinuation of glycopeptides in patients with culture negative severe sepsis or septic shock: A propensity-matched retrospective cohort study

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

Research output: Contribution to journalArticle

Abstract

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, P = 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, P = 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.

Original languageEnglish
Article number250
JournalAntibiotics
Volume9
Issue number5
DOIs
Publication statusPublished - 2020 May

All Science Journal Classification (ASJC) codes

  • Microbiology
  • Biochemistry
  • Pharmacology, Toxicology and Pharmaceutics(all)
  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)

Fingerprint Dive into the research topics of 'Discontinuation of glycopeptides in patients with culture negative severe sepsis or septic shock: A propensity-matched retrospective cohort study'. Together they form a unique fingerprint.

  • Cite this