Association between the appropriate antimicrobial therapy and clinical outcomes in patients with sepsis

Sepsis is the leading cause of death in hospitals, but appropriate antimicrobial therapy can reduce the mortality rate and improve the clinical outcome. This prospective study analyzed the association between appropriate antimicrobial therapy and clinical outcomes in patients with sepsis or septic shock who visited at Siriraj Hospital from July to September 2016. A total of 200 patients were enrolled, 65% had sepsis and 35% had septic shock, while 48.5% were diagnosed with community-acquired infections. Appropriate antimicrobial therapy, in terms of the four-criteria of, (i) administration of antimicrobials within 1 h post-diagnosis, (ii) empirical treatment, (iii) loading dose, and (iv) dose adjustment in renal failure, was significantly associated with a resolved clinical outcome at 7 days post-diagnosis (dpd; P = 0.044) and decreased mortality rate at 28 dpd (P = 0.034). Completion all six-criteria of appropriate antimicrobial therapy (the above four plus (v) antimicrobial adjustment to match the culture results and (vi) selection of the correct solvent for administration) were significantly associated with a better clinical outcome at 7 dpd (P = 0.018) and decreased mortality rate at 28 dpd (P = 0.02). Sepsis patients who received appropriate antimicrobial therapy showed an improved clinical outcome and increased the survival rate.