Impact of combination therapy with aminoglycosides on the outcome of ICU-acquired bacteraemias. Delannoy, P., Boussekey, N., Devos, P., Alfandari, S., Turbelin, C., Chiche, A., Meybeck, A., Georges, H., & Leroy, O. European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 31(9):2293–2299, September, 2012.
doi  abstract   bibtex   
Pharmacodynamic studies report on the rapid bactericidal activity of aminoglycosides, conferring them as being of theoretical interest for bacteraemia treatment. We assessed this issue in a retrospective study of patients with intensive care unit (ICU)-acquired bacteraemias. To determine the impact of aminoglycosides in antimicrobial combination on the outcome of patients with bacteraemia, we performed a monovariate analysis and a logistic regression analysis comparing patients treated with or without aminoglycosides. Forty-eight bacteraemias in 48 patients were included. Eighteen patients received aminoglycosides. Baseline characteristics as well as adaptation and adequation of antibiotherapy did not differ in patients who did or did not receive aminoglycosides. Patients who received aminoglycosides had longer time alive away from the ICU (11.3 +/- 8.9 (10 [0-20]) vs. 3.2 +/- 6.6 (0 [0-2] days; p = 0.002) and free from mechanical ventilation (12.5 +/- 9.3 (14 [0-21] vs. 5.5 +/- 9.2 (0 [0-10] days; p = 0.02) on day 28. The ICU mortality was 16% in the aminoglycoside group versus 46% (p = 0.03). In the multivariate analysis, patients treated with aminoglycosides were 6 times less likely to die than those treated without aminoglycosides (confidence interval [CI] = [1.3-28.9]; p = 0.02). Our study supports the hypothesis that combination short-term antibiotherapy with an aminoglycoside for ICU-acquired bacteraemias could increase survival.
@article{delannoy_impact_2012,
	title = {Impact of combination therapy with aminoglycosides on the outcome of {ICU}-acquired bacteraemias.},
	volume = {31},
	issn = {1435-4373 0934-9723},
	doi = {10.1007/s10096-012-1568-z},
	abstract = {Pharmacodynamic studies report on the rapid bactericidal activity of aminoglycosides, conferring them as being of theoretical interest for bacteraemia treatment. We assessed this issue in a retrospective study of patients with intensive care unit (ICU)-acquired bacteraemias. To determine the impact of aminoglycosides in antimicrobial combination on the outcome of patients with bacteraemia, we performed a monovariate analysis and a logistic regression analysis comparing patients treated with or without aminoglycosides. Forty-eight  bacteraemias in 48 patients were included. Eighteen patients received aminoglycosides. Baseline characteristics as well as adaptation and adequation of antibiotherapy did not differ in patients who did or did not receive aminoglycosides. Patients who received aminoglycosides had longer time alive away from the ICU (11.3 +/- 8.9 (10 [0-20]) vs. 3.2 +/- 6.6 (0 [0-2] days; p = 0.002)  and free from mechanical ventilation (12.5 +/- 9.3 (14 [0-21] vs. 5.5 +/- 9.2 (0  [0-10] days; p = 0.02) on day 28. The ICU mortality was 16\% in the aminoglycoside group versus 46\% (p = 0.03). In the multivariate analysis, patients treated with  aminoglycosides were 6 times less likely to die than those treated without aminoglycosides (confidence interval [CI] = [1.3-28.9]; p = 0.02). Our study supports the hypothesis that combination short-term antibiotherapy with an aminoglycoside for ICU-acquired bacteraemias could increase survival.},
	language = {eng},
	number = {9},
	journal = {European journal of clinical microbiology \& infectious diseases : official publication of the European Society of Clinical Microbiology},
	author = {Delannoy, P.-Y. and Boussekey, N. and Devos, P. and Alfandari, S. and Turbelin, C. and Chiche, A. and Meybeck, A. and Georges, H. and Leroy, O.},
	month = sep,
	year = {2012},
	pmid = {22350387},
	keywords = {Humans, Anti-Bacterial Agents/*therapeutic use, Female, Aged, Intensive Care Units, Male, Middle Aged, Survival Analysis, Treatment Outcome, Aminoglycosides/*therapeutic use, Bacteremia/*drug therapy, Cross Infection/*drug therapy, Drug Therapy, Combination/methods},
	pages = {2293--2299}
}

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