Antibiotic use and impact on outcome from bacteraemic critical illness: The bacteraemia study in intensive care (BASIC)

Alberto Corona, Guido Bertolini, Jeff Lipman, A. Peter Wilson, Mervyn Singer

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

Background: The lack of prospective, randomized, controlled trial data to guide optimal antibiotic use in bacteraemic critically ill patients has led to a wide variety of strategies and major issues with drug resistance. We therefore prospectively investigated the epidemiology of bacteraemia and fungaemia in intensive care units (ICUs); and the impact of timing, type and appropriateness of antibiotic intervention. Methods: We conducted a multinational, multicentre, prospective observational study in 132 ICUs from 26 countries with no interventions. Results: 1702 patients [European (69.6%), Australasian (12.2%), South American (8.3%) and Asian (9.9%)] developed 1942 bacteraemic episodes over the study period. Mortality rates were similar for those receiving empirical (40.5%), semi-targeted (37.6%) or fully targeted (33.3%) antibiotic therapy (P=0.40), and in those initially receiving broad(39.3%) or restricted-spectrum (39.1%) therapy (P=0.94). First-line therapy was effective in terms of the antibiogram (where available) in 70.4% of cases. This in vitro susceptibility ranged from 76.3% for broad-spectrum antibiotics to 46.3% for restricted-spectrum antibiotics (P

Original languageEnglish
Article numberdkq088
Pages (from-to)1276-1285
Number of pages10
JournalJournal of Antimicrobial Chemotherapy
Volume65
Issue number6
DOIs
Publication statusPublished - Mar 24 2010

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Critical Care
Bacteremia
Critical Illness
Anti-Bacterial Agents
Intensive Care Units
Fungemia
Asian Americans
Microbial Sensitivity Tests
Drug Resistance
Observational Studies
Epidemiology
Therapeutics
Randomized Controlled Trials
Prospective Studies
Mortality

Keywords

  • Antibiotic strategy
  • Bloodstream infections
  • Critically ill patients
  • Prevalence

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Antibiotic use and impact on outcome from bacteraemic critical illness : The bacteraemia study in intensive care (BASIC). / Corona, Alberto; Bertolini, Guido; Lipman, Jeff; Wilson, A. Peter; Singer, Mervyn.

In: Journal of Antimicrobial Chemotherapy, Vol. 65, No. 6, dkq088, 24.03.2010, p. 1276-1285.

Research output: Contribution to journalArticle

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