Cargando…
A simple mathematical model to determine the ideal empirical antibiotic therapy for bacteremic patients
BACKGROUND: Local epidemiological data are always helpful when choosing the best antibiotic regimen, but it is more complex than it seems as it may require the analysis of multiple combinations. The aim of this study was to demonstrate a simplified mathematical calculation to determine the most appr...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2014
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9427507/ https://www.ncbi.nlm.nih.gov/pubmed/24594099 http://dx.doi.org/10.1016/j.bjid.2013.11.006 |
_version_ | 1784778919625359360 |
---|---|
author | Tuon, Felipe F. Rocha, Jaime L. Leite, Talita M. Dias, Camila |
author_facet | Tuon, Felipe F. Rocha, Jaime L. Leite, Talita M. Dias, Camila |
author_sort | Tuon, Felipe F. |
collection | PubMed |
description | BACKGROUND: Local epidemiological data are always helpful when choosing the best antibiotic regimen, but it is more complex than it seems as it may require the analysis of multiple combinations. The aim of this study was to demonstrate a simplified mathematical calculation to determine the most appropriate antibiotic combination in a scenario where monotherapy is doomed to failure. METHODS: The susceptibility pattern of 11 antibiotics from 216 positive blood cultures from January 2012 to January 2013 was analyzed based on local policy. The length of hospitalization before bacteremia and the unit (ward or intensive care unit) were the analyzed variables. Bacteremia was classified as early, intermediate or late. The antibiotics were combined according to the combination model presented herein. RESULTS: A total of 55 possible mathematical associations were found combining 2 by 2, 165 associations with 3 by 3 and 330 combinations with 4 by 4. In the intensive care unit, monotherapy never reached 80% of susceptibility. In the ward, only carbapenems covered more than 90% of early bacteremia. Only three drugs combined reached a susceptibility rate higher than 90% anywhere in the hospital. Several regimens using four drugs combined reached 100% of susceptibility. CONCLUSIONS: Association of three drugs is necessary for adequate coverage of empirical treatment of bacteremia in both the intensive care unit and the ward. |
format | Online Article Text |
id | pubmed-9427507 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-94275072022-09-01 A simple mathematical model to determine the ideal empirical antibiotic therapy for bacteremic patients Tuon, Felipe F. Rocha, Jaime L. Leite, Talita M. Dias, Camila Braz J Infect Dis Original Article BACKGROUND: Local epidemiological data are always helpful when choosing the best antibiotic regimen, but it is more complex than it seems as it may require the analysis of multiple combinations. The aim of this study was to demonstrate a simplified mathematical calculation to determine the most appropriate antibiotic combination in a scenario where monotherapy is doomed to failure. METHODS: The susceptibility pattern of 11 antibiotics from 216 positive blood cultures from January 2012 to January 2013 was analyzed based on local policy. The length of hospitalization before bacteremia and the unit (ward or intensive care unit) were the analyzed variables. Bacteremia was classified as early, intermediate or late. The antibiotics were combined according to the combination model presented herein. RESULTS: A total of 55 possible mathematical associations were found combining 2 by 2, 165 associations with 3 by 3 and 330 combinations with 4 by 4. In the intensive care unit, monotherapy never reached 80% of susceptibility. In the ward, only carbapenems covered more than 90% of early bacteremia. Only three drugs combined reached a susceptibility rate higher than 90% anywhere in the hospital. Several regimens using four drugs combined reached 100% of susceptibility. CONCLUSIONS: Association of three drugs is necessary for adequate coverage of empirical treatment of bacteremia in both the intensive care unit and the ward. Elsevier 2014-03-01 /pmc/articles/PMC9427507/ /pubmed/24594099 http://dx.doi.org/10.1016/j.bjid.2013.11.006 Text en © 2014 Elsevier Editora Ltda. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Tuon, Felipe F. Rocha, Jaime L. Leite, Talita M. Dias, Camila A simple mathematical model to determine the ideal empirical antibiotic therapy for bacteremic patients |
title | A simple mathematical model to determine the ideal empirical antibiotic therapy for bacteremic patients |
title_full | A simple mathematical model to determine the ideal empirical antibiotic therapy for bacteremic patients |
title_fullStr | A simple mathematical model to determine the ideal empirical antibiotic therapy for bacteremic patients |
title_full_unstemmed | A simple mathematical model to determine the ideal empirical antibiotic therapy for bacteremic patients |
title_short | A simple mathematical model to determine the ideal empirical antibiotic therapy for bacteremic patients |
title_sort | simple mathematical model to determine the ideal empirical antibiotic therapy for bacteremic patients |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9427507/ https://www.ncbi.nlm.nih.gov/pubmed/24594099 http://dx.doi.org/10.1016/j.bjid.2013.11.006 |
work_keys_str_mv | AT tuonfelipef asimplemathematicalmodeltodeterminetheidealempiricalantibiotictherapyforbacteremicpatients AT rochajaimel asimplemathematicalmodeltodeterminetheidealempiricalantibiotictherapyforbacteremicpatients AT leitetalitam asimplemathematicalmodeltodeterminetheidealempiricalantibiotictherapyforbacteremicpatients AT diascamila asimplemathematicalmodeltodeterminetheidealempiricalantibiotictherapyforbacteremicpatients AT tuonfelipef simplemathematicalmodeltodeterminetheidealempiricalantibiotictherapyforbacteremicpatients AT rochajaimel simplemathematicalmodeltodeterminetheidealempiricalantibiotictherapyforbacteremicpatients AT leitetalitam simplemathematicalmodeltodeterminetheidealempiricalantibiotictherapyforbacteremicpatients AT diascamila simplemathematicalmodeltodeterminetheidealempiricalantibiotictherapyforbacteremicpatients |