Impact of appropriate antimicrobial therapy on survival in patients with Acinetobacter baumannii-associated infections

Objective: To assess the impact of inappropriate antimicrobial treatment on the 30-day mortality in patients with Acinetobacter baumannii associated infections. Methods: 87 patients with nosocomial infections caused by A. baumannii were included in the study. Among them 39 patients had favorable outcome, while 48 patients died within 30 days after pathogen isolation. In order to assess the impact of antimicrobial therapy on outcomes, the cases with appropriate antimicrobial treatment from both studied groups were compared with the cases in which patient’s received inappropriate therapy. The Chi-square or Z-test was used to assess differences in categorical variables. Continuous variables were compared using the Mann-Whitney test. Results: Among patients with favorable outcomes four people received appropriate empirical antimicrobial treatment, while in the other group only three patients. The odds ratio was 1.7 (95% CI 0.4-8.2; p=0.77). Appropriate antimicrobial agents were administered as a part of causal treatment to 27 patients who survived and to 11 patients who died within 30 days after pathogen isolation. The odds ratio was 6.7 (95% CI 2.6-17.3; p<0.001). Conclusion: Our study has revealed that appropriate causal antimicrobial therapy decreases 30-day mortality rate in patients with nosocomial infections caused by A. baumannii . J Microbiol Infect Dis 2013;3(4): 163-168