Inadequate Antibiotic Therapy in Solid Organ Transplant Recipients Is Associated with a Higher Mortality Rate

Sepsis in standard care: patients’ characteristics, effectiveness of antimicrobial therapy and patient outcome—a cohort study

“…The association between inappropriate empiric antibiotic therapy and increased hospital mortality is shown for several patient cohorts, including ICU patients [31,32], patients in the emergency room [33] or in solid organ recipients [34]. However, hardly any data are available for standard care setting patients.…”

Antibiotic-Resistant Infections and Treatment Challenges in the Immunocompromised Host

“…In the study by Men and colleagues, 23 75% of patients with inappropriate antibiotics perished compared with 32% of those on correct antibiotics. And, last, Lupei and colleagues 31 found that the 28-day mortality for those on inappropriate antibiotics at 24 hours was 14%, compared with 2% of those on appropriate antibiotics. This last study investigated the risks associated with inadequate antibiotics and found that younger age, longer courses of intravenous antibiotics before transplant, and greater duration of stay before transplant were associated.…”

“…Several studies showed that specific types of transplants were risk factors with liver transplant significant in 1 study, 22 lung transplantation in another, 20 and kidney transplantation in a third21, however, the other studies did Treatment Challenges in the Immunocompromised Host not show significance for any specific type of transplant, so there is likely no association. Risk factors that were found to be significant in more than 1 study included prior transplant, 7,16 length of stay before infection, 20,31 advancing age, 16,20 hemodialysis, 15,21 and prior antibiotic. 7,15,19,31 As far as antecedent antibiotics are concerned, XDR A baumannii and carbapenem-resistant A baumannii were found to be associated with prior carbapenem use.…”

“…Risk factors that were found to be significant in more than 1 study included prior transplant, 7,16 length of stay before infection, 20,31 advancing age, 16,20 hemodialysis, 15,21 and prior antibiotic. 7,15,19,31 As far as antecedent antibiotics are concerned, XDR A baumannii and carbapenem-resistant A baumannii were found to be associated with prior carbapenem use. 15,19 Greater acuity of illness was found to be associated with resistant pathogens in several studies with septic shock, 7 admission to the intensive care unit, 31 and respiratory failure 31 being associated in 3 separate studies.…”

“…7,15,19,31 As far as antecedent antibiotics are concerned, XDR A baumannii and carbapenem-resistant A baumannii were found to be associated with prior carbapenem use. 15,19 Greater acuity of illness was found to be associated with resistant pathogens in several studies with septic shock, 7 admission to the intensive care unit, 31 and respiratory failure 31 being associated in 3 separate studies.…”