Summary
Patients with gram-negative bacteremia studied between 1951–1958 (173 patients) and 1965–1974 (612 patients) were carefully evaluated to delineate critical determinants of outcome. Severity of the host's underlying disease was the major factor influencing outcome in both series. Early appropriate antibiotic therapy was associated with significant reductions in both fatality rates and the frequency of development of shock. Appropriate antibiotic therapy was also associated with a significant reduction in fatality rates even if initiated after the onset of shock. Most individual antimicrobial agents appeared to be of comparable efficacy provided the infecting organism was susceptible. Combinations of antibiotics could not be demonstrated to be more effective than single agents.
Zusammenfassung
Patienten mit gramnegativer Bakteriämie, die zwischen 1951–1958 (173 Patienten) und 1965–1974 (612 Patienten) untersucht wurden, wurden sorgfältig auf die kritischen Determinanten des Ausgangs der Erkrankung hin analysiert. Die Schwere der Grunderkrankung war der Faktor, der den Ausgang bei beiden Serien hauptsächlich beeinflußte. Frühzeitige, angemessene Antibiotikatherapie war mit einer signifikanten Verminderung sowohl der Letalität als auch der Häufigkeit der Schockentwicklung assoziiert. Angemessene Antibiotikatherapie war auch mit einer signifikanten Verminderung der Letalität assoziiert, wenn sie nach dem Eintreten des Schocks begonnen wurde. Die meisten einzelnen anti-mikrobiellen Substanzen schienen vergleichbare Effektivität zu besitzen, vorausgesetzt, der infizierende Keim war empfindlich. Es konnte nicht gezeigt werden, daß Antibiotikakombinationen wirksamer waren als Einzelsubstanzen.
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McCabe, W.R., Kreger, B.E. & Craven, D.E. Principles of antibiotic treatment of gram-negative bacteremia. Infection 8, 235–241 (1980). https://doi.org/10.1007/BF01639044
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DOI: https://doi.org/10.1007/BF01639044