Empiric therapy of sepsis in the surgical intensive care unit with broad-spectrum antibiotics for 72 hours does not lead to the emergence of resistant bacteria

Nicholas Namias, Sarah Harvill, Suzette Ball, Mark G. McKenney, Jeffrey P. Salomone, Danny Sleeman, Joseph M. Civetta

Research output: Contribution to journalArticle

26 Scopus citations

Abstract

Background: It is our practice to treat suspected sepsis with imipenem/cilastatin and gentamicin (IMP/GENT) for 72 hours while awaiting culture results. We wanted to determine if this practice engenders antimicrobial resistance. Methods: Review of prospectively collected data regarding use of IMP/GENT and microbial sensitivity to imipenem/cilastatin during the first and last 7 months of a 19-month study period (October 1, 1995, to April 30, 1997). Results: The susceptibility of appropriate organisms to imipenem/cilastatin was 76% in the early period and 80% in the late period (p = 0.42). Pseudomonas aeruginosa was more susceptible in the late period (88 vs. 62%; p = 0.007). Resistance to gentamicin (30% early vs. 21% late; p = 0.02) and representative cephalosporins (cefoxitin, 52% early vs. 61% late; p = 0.35; ceftazidime, 26% early vs. 23% late; p = 0.76) did not develop during the study period. The incidence of fungemia was the same in both periods (4 of 467 admissions vs. 3 of 599 admissions; p = 0.48). Conclusion: This protocol did not lead to the emergence of resistant bacteria.

Original languageEnglish (US)
Pages (from-to)887-891
Number of pages5
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume45
Issue number5
DOIs
StatePublished - Nov 1998

Keywords

  • Antibiotics
  • Drug resistance, microbial
  • Imipenem/cilastin

ASJC Scopus subject areas

  • Surgery

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