Impact of timing of antibiotic bundle therapy on outcomes in septic shock patients: a multicenter retrospective investigation
10.3760/cma.j.issn.1671-7368.2018.02.012
- VernacularTitle:抗菌药物应用时间对感染性休克病死率影响的回顾性研究
- Author:
Xiaoyan WU
1
;
Lei BAO
;
Weili LIU
;
Jilu YE
;
Ruiqiang ZHENG
Author Information
1. 江苏省苏北人民医院重症医学科
- Keywords:
Shock,septic;
Combined modality therapy;
Anti-bacterial agents;
Hospital mortality
- From:
Chinese Journal of General Practitioners
2018;17(2):133-135
- CountryChina
- Language:Chinese
-
Abstract:
The clinical data of 372 patients with septic shock admitted in departments of critical care medicine of three Grade A tertiary hospitals from January 2013 to December 2015 were retrospectively reviewed,including 211 survival cases and 161 fatal cases.According to septic shock early goal-directed therapy implementation,117 patients received bundle therapy (bundle group),including 30 cases with bundle goal-fully achieved,and 87 cases with bundle goal-partly achieved;and 255 cases received conventional treatment (non-bundle group).Muhiple logistic regression analysis showed that the multiple organ dysfunction syndrome score,length of ICU stay and first time using of antibiotics were independent risk factors for prognosis of septic shock (P ＜ 0.05).There was no significant difference in case fatality rate between bundle group and non-bundle group (46.2％ vs.42.0％,P ＞ 0.05),while the fatality in bundle goal-fully achieved group(20.0％)was significantly lower than that of goal-partly achieved group (55.2％) and non-bundle group (42.0％) (P ＜ 0.05).Survival curve analysis showed that the medial survival time in bundle goal-fully achieved group was significantly higher than that in non-bundle group (19.4 vs.10.5 days,P ＜0.05) and that in control group plus goal-partly achieved group(19.4 vs.12.9 days,P ＜0.05).Multiple Logistic regression analysis showed that central venous oxygen saturation and antibiotics using within one hour were protective factors for prognosis of septic shock (P ＜ 0.05).The results indicate that antibiotic bundle treatment of all indicators up to standards could significantly reduce the mortality of septic patients and early antibiotics is important in bundle treatment.
