Clinical Study

Impact of Inappropriate Empiric Antimicrobial Therapy on Mortality of Septic Patients with Bacteremia: A Retrospective Study

Table 5

Univariate analysis of factors associated with 28-day and overall mortality.

FactorsTotal n (%)28-day mortality n (%) valueOR (95% CI)Overall mortality n (%) valueOR (95% CI)

Age > 65 yrs111 (48.5)74 (66.7)0.2211.42 (0.83–2.43)86 (77.5)0.0301.97 (1.10–3.53)
Nosocomial infection81 (35.4)55 (67.9)0.1081.44 (0.82–2.55)65 (80.2)0.0162.20 (1.16–4.18)
Septic shock140 (61.1)96 (68.6)0.0171.95 (1.13–3.38102 (72.9)0.2001.36 (0.77–2.43)
Inappropriate first dose68 (42.79)46 (67.6)0.2921.38 (0.76–2.51)51 (75.0)0.2131.39 (0.73–2.64)
Inappropriate 24-hour dose58 (25.33)38 (65.5)0.1761.19 (0.64–2.23)43 (74.1)0.1601.29 (0.66–2.52)
Duration from sepsis until
first-dose antimicrobial
therapy > 3 hours
117 (51.1)79 (67.5)0.1061.56 (0.91–2.67)90 (76.9)0.0261.93 (1.08–3.43)
Wbc ≤ 4,000 per uL40 (17.5)33 (82.5)0.0043.39 (1.43–8.04)34 (85.0)0.0352.77 (1.10–6.94)
Plt ≤ 100,000 per uL109 (47.6)82 (75.2)<0.0012.94 (1.67–5.16)88 (80.7)0.0012.698 (1.48–4.92)
HCO3 ≤ 20 mEq/L135 (59.0)92 (68.1)0.0381.80 (1.05–3.11)96 (71.1)0.7701.10 (0.62–1.95)
Albumin ≤ 3.2 g/dL171 (74.7)117 (68.4)0.0022.67 (1.45–4.91)128 (74.9)0.0132.26 (1.21–4.21)
APACHE II score ≥ 25100 (43.7)79 (79.0)<0.0013.82 (2.11–6.90)81 (81.0)0.0022.61 (1.41–4.82)
Serum cortisol ≥ 35 mg/dL
( )
38 (59.4)29 (76.3)0.0094.39 (1.49–12.93)30 (78.9)0.0293.75 (1.25–11.21)
Serum lactate ≥ 2.2 mmol/L
( )
26 (83.9)20 (76.9)0.02713.33 (1.24–143.15)20 (76.9)0.02713.33 (1.24–143.15)
Comorbidity > 484 (36.7)61 (42.7)0.0172.04 (1.14–3.64)69 (42.9)0.0032.65 (1.38–5.09)
Liver failure50 (21.8)38 (26.6)0.0312.23 (1.09–4.56)42 (26.1)0.0222.65 (1.17–5.99)
Congestive heart failure50 (21.8)38 (26.6)0.0312.23 (1.09–4.56)41 (25.5)0.0532.24 (1.02–4.92)
High-risk source*129 (56.3)89 (69.0)0.0271.90 (1.1–3.26)101 (78.3)0.0032.41 (1.35–4.29)
Respiratory75 (32.8)54 (72.0)0.0421.88 (1.03–3.41)64 (85.3)<0.0013.42 (1.67–7.01)
Intra-abdomen54 (23.6)35 (64.8)0.7491.14 (0.61–2.16)37 (68.5)0.7360.90 (0.46–1.73)
Genitourinary47 (20.5)20 (14.0)0.0020.36 (0.18–0.69)24 (51.0)0.0020.34 (0.18–0.67)
Skin and soft tissue18 (7.9)11 (61.1)1.0000.94 (0.35–2.53)12 (66.7)0.7890.83 (0.30–2.32)
Monotherapy-inappropriate45 (19.65)28 (62.2)0.6321.19 (0.58–2.45)32 (71.1)0.6231.21 (0.56–2.61)
Monotherapy-appropriate100 (43.67)58 (58.0)67 (67.0)
Combination-inappropriate21 (9.17)16 (76.2)0.3061.81 (0.58–5.60)17 (81.0)0.3551.78 (0.53–6.03)
Combination-appropriate61 (26.64)39 (63.9)43 (70.5)

*Respiratory and Intra-abdominal [15, 16].