Managing adult patients with infectious diseases in emergency departments: international ID-IRI study
- Authors: Erdem H.; Hargreaves S.; Ankarali H.; Caskurlu H.; Ceviker S.A.; Bahar-Kacmaz A.; Meric-Koc M.; Altindis M.; Yildiz-Kirazaldi Y.; Kizilates F.; Alsalman J.; Cag Y.; Kamal A.H.M.; Dokmetas I.; Dindar-Demiray E.K.; Shehata G.A.; Hasman H.; Sadykova A.; Llopis F.; Ramosaco E.; Logar M.; Alay H.; Kesmez-Can F.; Ruch Y.; Bulut D.; Makek M.J.; Marino A.; Mahboob A.; El-Kholy A.; Abdallah D.; Sefa-Sayar M.; Karaali R.; Aslan S.; Dar R.E.; Abdalla E.; Monzon-Camps H.; Baljic R.; Mgdalena D.I.; Naghili B.; Abbas Dafalla M.E.; Alwashmi A.S.S.; Carmen C.R.; Ramirez-Estrada S.; Wojewodzka-Zelezniakowicz M.; Akyildiz O.; Zajkowska J.; El-Sokkary R.; Pandya N.; Amer F.; Alavi-Darazam I.; Grgic S.; Wegdan A.A.; El-Kholy J.; Bulut-Avsar C.; Kulzhanova S.; Tasbakan M.; Kumari H.P.; Dirani N.; Koganti K.; Konkayev A.K.; Petrov M.M.; Cascio A.; Liskova A.; Del Vecchio R.F.; Lambertenghi L.; Mladenov N.; Oncu S.; Rello J.
- Publication year: 2021
- Type: Articolo in rivista
- OA Link: http://hdl.handle.net/10447/534222
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.