Delays in antibiotic redosing: Association with inpatient mortality and risk factors for delay.

摘要: Abstract Objective Although timely administration of antibiotics has an established benefit in serious bacterial infection, the majority studies evaluating antibiotic delay focus only on first dose. Recent evidence suggests that delays redosing may also be associated with worse clinical outcome. In light increasing burden boarding Emergency Departments (ED) and subsequent need to redose ED, we examined association between delayed second dose mortality among patients admitted from ED a broad array infections characterized risk factors administration. Methods We performed retrospective cohort study through five EDs single healthcare system 1/2018 12/2018. Our included all patients, aged 18 years or older, who received two intravenous doses within 30-h period, administered ED. Patients end stage renal disease, cirrhosis extremes weight were excluded due lack consensus dosing intervals for these populations. Delay was defined as at time-point greater than 125% recommended interval. The primary outcome in-hospital mortality. Results A total 5605 doses, occurring during 4904 visits, met criteria. Delayed occurred 21.1% visits. After adjustment patient characteristics, increased odds (OR 1.50, 95%CI 1.05–2.13). Regarding delay, every one-hour increase allowable compliance time 18% decrease 0.82 0.75–0.88). Other more 4 h 1.47, 1.27–1.71) high acuity presentation by emergency severity index (ESI) 1.54, 1.30–1.81 ESI 1–2 versus 3–5). Conclusions Delays frequent early hospital course, Several administration, including boarding, identified.