Impact of Inappropriate Antibiotic Therapy in Vancomycin-Resistant Enterococcus Bacteremia

Area of Science:

• Infectious Diseases
• Clinical Microbiology
• Pharmacology

Background:

• Vancomycin-resistant Enterococcus (VRE) bacteremia presents a significant challenge due to high morbidity and mortality.
• Empiric antibiotic regimens may not adequately cover VRE, necessitating targeted treatment strategies.

Purpose of the Study:

• To evaluate the impact of antibiotic therapy and other risk factors on mortality in patients with VRE bacteremia.

Main Methods:

• Retrospective analysis of electronic medical records for 128 patients with VRE bacteremia from 2004-2014.
• Data collected included patient demographics, antibiotic prescriptions, and clinical outcomes.

Main Results:

• Inpatient, 30-day, and 1-year mortality rates were 23%, 31%, and 59%, respectively.
• Inappropriate antibiotic therapy was associated with significantly higher 30-day (54% vs. 26%) and 1-year (67% vs. 50%) mortality.
• Advanced age, septic shock, low albumin, and dementia were also linked to increased 30-day mortality.

Conclusions:

• Inappropriate antibiotic therapy is a critical determinant of mortality in VRE bacteremia.
• Timely and appropriate antibiotic selection is essential for improving outcomes in VRE infections.