Patient selection: Gram-negative sepsis
Outcome: ineffective empiric therapy (Initial antibiotic regimen not active against isolate based on in vitro susceptibility testing. For a polymicrobic infection, all isolates must be susceptible to be considered effective.)
Risk factors for ineffective therapy with early-onset sepsis (< 48 hours since admission):
(1) age (mean 64.7 years, vs 61.9 for effective therapy)
(2) recent hospitalization
(3) prior intravenous antibiotics
Risk factors for ineffective therapy with late-onset sepsis (>= 48 hours of admission):
(1) length of hospital stay prior to onset of sepsis (hospital-acquired)
(2) prior intravenous antibiotics
Some of these risk factors are associated with infection by antibiotic-resistant organisms. The resistance of isolates is discussed in the section "Antimicrobial susceptibility testing and local antibiogram.
