Managing adult patients with infectious diseases in emergency departments: international ID-IRI study


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Erdem H., Hargreaves S., Ankaralı H., Caskurlu H., Alkan Çeviker S. , Bahar-Kacmaz ., ...Daha Fazla

Journal Of Chemotherapy, cilt.1, sa.1, ss.1-17, 2021 (SCI İndekslerine Giren Dergi)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 1 Konu: 1
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1080/1120009x.2020.1863696
  • Dergi Adı: Journal Of Chemotherapy
  • Sayfa Sayıları: ss.1-17

Özet

Abstract

We aimed to explore factors for optimizing antimicrobial treatment in emergency departments. A single-day point prevalence survey was conducted on January 18, 2020, in 53 referral/tertiary hospitals in 22 countries. 1957 (17%) of 11557 patients presenting to EDs had infections. The mean qSOFA score was 0.37 ± 0.74. Sepsis (qSOFA ≥ 2) was recorded in 218 (11.1%) patients. The mean qSOFA score was significantly higher in low-middle (1.48 ± 0.963) compared to upper-middle (0.17 ± 0.482) and high-income (0.36 ± 0.714) countries (P < 0.001). Eight (3.7%) patients with sepsis were treated as outpatients. The most common diagnoses were upper-respiratory (n = 877, 43.3%), lower-respiratory (n = 316, 16.1%), and lower-urinary (n = 201, 10.3%) infections. 1085 (55.4%) patients received antibiotics. The most-commonly used antibiotics were beta-lactam (BL) and BL inhibitors (n = 307, 15.7%), third-generation cephalosporins (n = 251, 12.8%), and quinolones (n = 204, 10.5%). Irrational antibiotic use and inappropriate hospitalization decisions seemed possible. Patients were more septic in countries with limited resources. Hence, a better organizational scheme is required.

Keywords: Emergency; antibiotic; elderly; infection; sepsis; treatment.