ICU-acquired nosocomial infection: impact of delay in adequate antibiotic treatment

Appropriateness and delay to initiate therapy in ventilator-associated pneumonia

“…This difference remained after adjusting for the number of organ failures. This suggests that, during the course of nosocomial pneumonia and bacteraemia, the time at which appropriate antibiotic treatment is started is a key factor influencing survival [25]. This has also been demonstrated for S. aureus sepsis [26].…”

“…In a retrospective, cohort study on patients with ICU-acquired bacteraemic nosocomial infection or pneumonia, MATHEVON et al [25] observed that the mortality rate was significantly associated with the length of time without appropriate antibiotic treatment (p50.011) and the number of organ failures on the day of diagnosis (p50.017). Appropriate antibiotic treatment only had an impact on survival if it was started within the first 24 h after sampling (p,0.02 on day 0 and ,0.04 on day 1).…”

Time to Administration of Antibiotics among Inpatients with Severe Sepsis or Septic Shock

“…4,6 Guidelines from the campaign recommend initiation of broad-spectrum antibiotics within 1 h of recognition of severe sepsis or septic shock, a reflection of increasing evidence that supports timely and appropriate antibiotic therapy to improve morbidity and mortality in this patient population. [7][8][9][10][11][12] In a retrospective cohort study of patients with septic shock in the intensive care unit (ICU), Kumar and others 8 observed a 7.6% reduction in survival with each hour of delay in initiating effective antimicrobial therapy from the onset of hypotension. Existing literature has examined the delay in antibiotic therapy and its impact on patients with severe sepsis in the ICU and the emergency department, but few have studied inpatients in other hospital locations or factors that affect time to administration.…”

Pathogens in the lower respiratory tract of intensive care unit patients: Impact of duration of hospital care and mechanical ventilation

“…A further confounder is that any delay in adequate antibiotic treatment might contribute to increased mortality among VAP patients (113). In contrast, good standard of care including liberal bronchoscope cultures and proper use of antibiotics might be associated with less effect of VAP on mortality (16,58,72,100,121). In Paper II, restricted to trauma patients, we found no difference in 30 day mortality between patients with and without pneumonia.…”

“…Several studies have suggested that the prognosis for patients with VAP is better for trauma patients, than medical and surgical patients (24,27,47,69,76,104). Increased mortality has also been associated with delayed or absent adequate antibiotic treatment (59,72,104,113 (61). Late-onset VAP have been reported to be associated with higher mortality rates than early-onset VAP (3,16,64,80,119).…”