Clinical outcomes in combination versus mono antibiotic therapy in ICU admitted patients with a suspected infection - A substudy of the DIANA study

J Crit Care. 2024 Apr:80:154501. doi: 10.1016/j.jcrc.2023.154501. Epub 2023 Dec 20.

Abstract

Purpose: In a retrospective cohort study of intensive care unit (ICU) admitted adult patients with suspected or confirmed infection, associations between combination versus mono empirical antibiotic therapy and clinical cure at day 7 as well as mortality at day 7 and 28, were investigated.

Materials and methods: Patients from the DIANA study were grouped and analysed by combination versus mono antibiotic therapy. Clinical cure was defined as survival and resolution of all signs and symptoms related to the infection. Odds ratios (ORs) were calculated by logistic regression analyses.

Results: Of the 1398 included patients, 568 patients (41%) received combination therapy. In total, 641(46%) patients achieved clinical cure and 135 (10%) patients had died as of day 7. There were no significant associations between combination and mono therapy relating to clinical cure and mortality.

Conclusions: This study found no differences in clinical cure and mortality between empirical combination versus mono therapy in a large cohort of ICU patients with a suspected infection.

Keywords: Clinical cure; Empirical antibiotic therapy; ICU; Sepsis; Septic shock.

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Humans
  • Intensive Care Units
  • Retrospective Studies
  • Sepsis*
  • Shock, Septic*

Substances

  • Anti-Bacterial Agents