Impact of Empirical Antibiotic Regimens on Mortality in Neutropenic Patients with Bloodstream Infection Presenting with Septic Shock
Mariana Chumbita, Pedro Puerta-Alcalde, Carlota Gudiol, Nicole Garcia-Pouton, Júlia Laporte-Amargós, Andrea Ladino, Adaia Albasanz-Puig, Cristina Helguera, Alba Bergas, Ignacio Grafia, Enric Sastre, María Suárez-Lledó, Xavier Durà, Carlota Jordán, Francesc Marco, Maria Condom, Pedro Castro, Jose A. Martínez, Josep Mensa, Alex Soriano, Jordi Carratalà, Carolina Garcia-Vidal
Abstract
spp. or Gram-negative bacilli (OR, 3.8; 95% CI, 1.3 to 11.1), acute kidney injury (OR, 2.6; 95% CI, 1.4 to 4.9), and amikacin as the only active antibiotic (OR, 15.2; 95% CI, 1.7 to 134.5) were independent risk factors for mortality, while the combination of β-lactam and amikacin was protective (OR, 0.32; 95% CI, 0.18 to 0.57). Septic shock in febrile neutropenic patients with BSI is associated with extremely high mortality, especially when IEAT is administered. Combination therapy including an active β-lactam and amikacin results in the best outcomes.