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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Drug-related superinfection in hospitalized patients

A M Walker, H Jick, J Porter

    JAMA
    |September 21, 1979
    PubMed

    Insights

    Antibiotic therapy in hospitalized patients rarely leads to superinfections, with most being fungal. However, risk increases with immunosuppression and kidney dysfunction.

    Area of Science:

    • Infectious Diseases
    • Pharmacology
    • Nephrology

    Background:

    • Antibiotic use is common in hospitalized patients.
    • Superinfections can complicate antibiotic treatment.
    • Fungal infections are a known complication of antibiotic therapy.

    Purpose of the Study:

    • To determine the incidence of superinfections in hospitalized patients receiving antibiotics.
    • To identify the types of superinfections that occur.
    • To assess risk factors for superinfection development.

    Main Methods:

    • Retrospective analysis of 14,077 hospitalized medical patients.
    • Data collection on antibiotic use and superinfection development.
    • Statistical analysis to identify risk factors.

    Main Results:

    • Superinfection occurred in 0.7% (95 patients) of those receiving antibiotics.
    • The majority of superinfections were yeast and fungal.
    • Serious infections occurred in less than 1 in 1,000 patients.
    • Immunosuppression and impaired renal function were associated with increased risk.

    Conclusions:

    • Superinfections are uncommon during antibiotic therapy in hospitalized patients.
    • Fungal infections are the most frequent type of superinfection.
    • Patients with immunosuppression or renal impairment require closer monitoring for superinfections.

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