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JAC Advance Access published online on April 20, 2006
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkl130
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Received January 20, 2006
Revised March 10, 2006
Accepted March 20, 2006

Brief report

Comparison of mortality of patients with Acinetobacter baumannii bacteraemia receiving appropriate and inappropriate empirical therapy

Matthew E. Falagas 1 *, Sofia K. Kasiakou 2, Petros I. Rafailidis 2, George Zouglakis 2, and Panayiota Morfou 3

1 Alfa Institute of Biomedical Sciences (AIBS), Athens, Greece; Department of Medicine, Henry Dunant Hospital, Athens, Greece; Department of Medicine, Tufts University School of Medicine, Boston, MA, USA
2 Alfa Institute of Biomedical Sciences (AIBS), Athens, Greece
3 Department of Microbiology, Henry Dunant Hospital, Athens, Greece

* To whom correspondence should be addressed.
Matthew E. Falagas, E-mail: m.falagas{at}aibs.gr


  Abstract

Objectives: To evaluate the effect of inappropriate empirical antimicrobial treatment on the mortality of patients with Acinetobacter baumannii bacteraemia.

Methods: Retrospective cohort study of patients with A. baumannii bacteraemia hospitalized at the Henry Dunant hospital from January 2002 to December 2004.

Results: Among 40 patients with A. baumannii bacteraemia, 22 (55%) and 18 (45%) received inappropriate and appropriate antibiotic therapy, respectively, during the 3 day period after obtaining the blood culture(s) from which the pathogen was isolated. Failure to cure the infection was more common in the first group [16/22 patients (72.7%) versus 5/18 (27.8%), P = 0.005]. Although without statistical significance, probably due to the small number of studied patients, considerably increased mortality was noted in the first group compared with the second group [13/22 patients (59.1%) versus 6/18 (33.3%), P = 0.10].

Conclusions: A. baumannii bacteraemia was associated with worse outcome regarding the cure of infection in patients who received inappropriate empirical antimicrobial treatment compared with those who received appropriate treatment.

Keywords: appropriate therapy; inadequate therapy; Gram-negative bacteria; bloodstream infections; antimicrobial treatment.
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