MARC details
000 -LEADER |
fixed length control field |
04849nam a22007217a 4500 |
008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION |
fixed length control field |
150313s20142014 xxu||||| |||| 00| 0 eng d |
022 ## - INTERNATIONAL STANDARD SERIAL NUMBER |
International Standard Serial Number |
0090-3493 |
040 ## - CATALOGING SOURCE |
Original cataloging agency |
Ovid MEDLINE(R) |
099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC) |
PMID |
25072764 |
245 ## - TITLE STATEMENT |
Title |
Using the number needed to treat to assess appropriate antimicrobial therapy as a determinant of outcome in severe sepsis and septic shock. |
251 ## - Source |
Source |
Critical Care Medicine. 42(11):2342-9, 2014 Nov. |
252 ## - Abbreviated Source |
Abbreviated source |
Crit Care Med. 42(11):2342-9, 2014 Nov. |
253 ## - Journal Name |
Journal name |
Critical care medicine |
260 ## - PUBLICATION, DISTRIBUTION, ETC. |
Year |
2014 |
260 ## - PUBLICATION, DISTRIBUTION, ETC. |
Manufacturer |
FY2015 |
266 ## - Date added to catalog |
Date added to catalog |
2015-03-17 |
501 ## - WITH NOTE |
Local holdings |
Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006 |
520 ## - SUMMARY, ETC. |
Abstract |
CONCLUSIONS: Our results support the importance of appropriate antimicrobial treatment as a determinant of outcome in patients with severe sepsis and septic shock. Our analyses suggest that improved targeting of empiric antimicrobials for multidrug-resistant bacteria, Candida species, methicillin-resistant S. aureus, and P. aeruginosa would have the greatest impact in reducing mortality from inappropriate antimicrobial treatment in patients with severe sepsis and septic shock. |
520 ## - SUMMARY, ETC. |
Abstract |
DESIGN: Single-center cohort study (January 2008 to December 2012). |
520 ## - SUMMARY, ETC. |
Abstract |
INTERVENTIONS: We retrospectively identified patients with severe sepsis or septic shock. Inappropriate antimicrobial treatment was defined as an antimicrobial regimen that lacked in vitro activity against the isolated pathogen. Information regarding demographics, severity of illness, comorbidities, microbiology, and antimicrobial treatment was recorded. Logistic regression was used to identify risk factors for hospital mortality and inappropriate treatment. |
520 ## - SUMMARY, ETC. |
Abstract |
MEASUREMENTS AND MAIN RESULTS: Seven hundred eighty-seven patients (30.3%) were nonsurvivors. Inappropriate antimicrobial treatment had the greatest adjusted odds ratio for hospital mortality (adjusted odds ratio, 3.4; 95% CI, 2.8-4.1; p < 0.001). Multivariate logistic regression analysis identified resistance to cefepime, resistance to meropenem, presence of multidrug resistance, nonabdominal surgery, and prior antibiotic use as being independently associated with the administration of inappropriate antimicrobial treatment. For the entire cohort, the number needed to treat with appropriate antimicrobial therapy to prevent one patient death was 4.0 (95% CI, 3.7-4.3). The prevalence-adjusted pathogen-specific number needed to treat (PNNT) with appropriate antimicrobial therapy to prevent one patient death was lowest for multidrug-resistant bacteria (PNNT = 20) followed by Candida species (PNNT = 34), methicillin-resistant Staphylococcus aureus (PNNT = 38), Pseudomonas aeruginosa (PNNT = 38), Escherichia coli (PNNT = 40), and methicillin-susceptible S. aureus (PNNT = 47). |
520 ## - SUMMARY, ETC. |
Abstract |
OBJECTIVE: To assess appropriate antimicrobial therapy as an outcome determinant in severe sepsis and septic shock using the number needed to treat. |
520 ## - SUMMARY, ETC. |
Abstract |
PATIENTS: Two thousand five hundred ninety-four patients with positive blood culture. |
520 ## - SUMMARY, ETC. |
Abstract |
SETTING: One thousand two hundred fifty-bed academic hospital. |
546 ## - LANGUAGE NOTE |
Language note |
English |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
*Anti-Bacterial Agents/ad [Administration & Dosage] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
*Hospital Mortality |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
*Sepsis/dt [Drug Therapy] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
*Sepsis/mo [Mortality] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Adult |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Cohort Studies |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Female |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Follow-Up Studies |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Gram-Negative Bacteria/de [Drug Effects] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Gram-Negative Bacteria/ip [Isolation & Purification] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Gram-Positive Bacteria/de [Drug Effects] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Gram-Positive Bacteria/ip [Isolation & Purification] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Hospitalization/sn [Statistics & Numerical Data] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Humans |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Logistic Models |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Male |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Microbial Sensitivity Tests |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Middle Aged |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Multivariate Analysis |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Retrospective Studies |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Risk Assessment |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Sepsis/bl [Blood] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Shock, Septic/bl [Blood] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Shock, Septic/dt [Drug Therapy] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Shock, Septic/mo [Mortality] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Statistics, Nonparametric |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Survival Rate |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Treatment Outcome |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
United States |
651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME |
Institution |
MedStar Washington Hospital Center |
656 ## - INDEX TERM--OCCUPATION |
Department |
Medicine/Pulmonary-Critical Care |
657 ## - INDEX TERM--FUNCTION |
Medline publication type |
Journal Article |
657 ## - INDEX TERM--FUNCTION |
Medline publication type |
Research Support, Non-U.S. Gov't |
700 ## - ADDED ENTRY--PERSONAL NAME |
Local Authors |
Shorr, Andrew F |
790 ## - Authors |
All authors |
Kollef M, Micek ST, Scolari M, Shorr AF, Vazquez-Guillamet C, Zilberberg MD |
856 ## - ELECTRONIC LOCATION AND ACCESS |
DOI |
<a href="http://dx.doi.org/10.1097/CCM.0000000000000516">http://dx.doi.org/10.1097/CCM.0000000000000516</a> |
Public note |
http://dx.doi.org/10.1097/CCM.0000000000000516 |
942 ## - ADDED ENTRY ELEMENTS (KOHA) |
Koha item type |
Journal Article |
Item type description |
Article |