title: Evaluation of empiric antibiotic use in surgical sepsis.
abstract: BACKGROUND
  We performed an evaluation of antimicrobial guidelines for patients with surgical sepsis.
  
  
  METHODS
  The purpose of this study was to validate current empiric antibiotic recommendations in our sepsis protocol based on the suspected site of infection. The primary objective was to assess the appropriateness of empiric antibiotic recommendations and to determine if initial empiric antibiotics provided adequate coverage compared with sensitivity data (accuracy). Secondary end points included antibiotic protocol compliance, intensive care unit (ICU)-free days, and mortality.
  
  
  RESULTS
  Appropriate antibiotics were prescribed in 82% of patients. Of the culture-positive patients, 72% received accurate antibiotics. ICU-free days were greater for patients in the compliant group (14.5 vs 8.4; P = .014). Hospital mortality was greater in patients who were noncompliant with protocol recommendations (22% vs 17%; P = .44).
  
  
  CONCLUSIONS
  Our current antibiotic guidelines provide appropriate and accurate antimicrobial coverage. Noncompliance with the antibiotic protocol resulted in fewer ICU-free days and increased hospital mortality in surgical sepsis patients.
authors.affiliation: The Methodist Hospital, Houston, TX, USA.
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Fitousis
authors.forename: Laura Jane
authors.initials: LJ
authors.lastname: Moore
authors.forename: Jeffery
authors.initials: J
authors.lastname: Hall
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Moore
authors.forename: Steven
authors.initials: S
authors.lastname: Pass
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003428:Cross Infection / Q000188:drug therapy; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D018805:Sepsis / Q000188:drug therapy*; D012772:Shock, Septic / Q000188:drug therapy; D018746:Systemic Inflammatory Response Syndrome / Q000188:drug therapy; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents