Managing adult patients with infectious diseases in emergency departments: international ID-IRI study. (7th September 2021)

• Record Type: Journal Article
• Authors: Erdem, Hakan; Hargreaves, Sally; Ankarali, Handan; Caskurlu, Hulya; Ceviker, Sevil Alkan; Bahar-Kacmaz, Asiye; Meric-Koc, Meliha; Altindis, Mustafa; Yildiz-Kirazaldi, Yasemin; Kizilates, Filiz; Alsalman, Jameela; Cag, Yasemin; Kamal, Abu Hena Mostafa; Dokmetas, Ilyas; Dindar-Demiray, Emine Kubra; Shehata, Ghaydaa Ahmed; Hasman, Hakan; Sadykova, Ainur; Llopis, Ferran; Ramosaco, Ergys; Logar, Mateja; Alay, Handan; Kesmez-Can, Fatma; Ruch, Yvon; Bulut, Dilek; Makek, Mateja Jankovic; Marino, Andrea; Mahboob, Amjad; El-Kholy, Amani; Abdallah, Dirar; Sefa-Sayar, Merve; Karaali, Ridvan; Aslan, Selda; Dar, Razi Even; Abdalla, Esam; Monzón-Camps, Helena; Baljić, Rusmir; Mgdalena, Dumitru Irina; Naghili, Behrouz; Abbas Dafalla, Mohamed Elhassan; Alwashmi, Ameen S.S.; Carmen, Cernat Roxana; Ramirez-Estrada, Sergio; Wojewodzka-Zelezniakowicz, Marzena; Akyildiz, Ozay; Zajkowska, Joanna; El-Sokkary, Rehab; Pandya, Nirav; Amer, Fatma; Alavi-Darazam, Ilad; Grgić, Svjetlana; Wegdan, Ahmed Ashraf; El-Kholy, Jehan; Bulut-Avsar, Cansu; Kulzhanova, Sholpan; Tasbakan, Meltem; Kumari, Hema Prakash; Dirani, Natalia; Koganti, Kalyan; Konkayev, Aidos K.; Petrov, Michael M.; Cascio, Antonio; Liskova, Anna; Del Vecchio, Rosa Fontana; Lambertenghi, Lorenza; Mladenov, Nikolay; Oncu, Serkan; Rello, Jordi;
• Is Part Of: Journal of chemotherapy. Volume 33:Number 5(2021)
• Page Start: 302
• Page End: 318
• Publication Date: 2021-09-07
• Subjects: Emergency -- infection -- sepsis -- treatment -- antibiotic -- elderly; Chemotherapy -- Periodicals; Drug Therapy -- Periodicals; 615.58
• DOI: 10.1080/1120009X.2020.1863696
• Languages: English
• ISSNs: 1120-009X

Abstract

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.