Antibiotic treatment with one single dose of gentamicin at admittance in addition to a β-lactam antibiotic in the treatment of community-acquired bloodstream infection with sepsis

Karolina Liljedahl Prytz, Mårten Prag, Hans Fredlund, Anders Magnuson, Martin Sundqvist and Jan Källman

PLOS ONE, 2020, vol. 15, issue 7, 1-15

Abstract: Background: Combination therapy in the treatment of sepsis, especially the value of combining a β-Lactam antibiotic with an aminoglycoside, has been discussed. This retrospective cohort study including patients with sepsis or septic shock aimed to investigate whether one single dose of gentamicin at admittance (SGA) added to β-Lactam antibiotic could result in a lower risk of mortality than β-Lactam monotherapy, without exposing the patient to the risk of nephrotoxicity. Methods and findings: All patients with positive blood cultures were evaluated for participation (n = 1318). After retrospective medical chart review, a group of patients with community-acquired sepsis with positive blood cultures who received β-Lactam antibiotic with or without the addition of SGA (n = 399) were included for the analysis. Mean age was 74.6 yrs. (range 19–98) with 216 (54%) males. Sequential Organ Failure Assessment score (SOFA score) median was 3 (interquartile range [IQR] 2–5) and the median Charlson Comorbidity Index for the whole group was 2 (IQR 1–3). Sixty-seven (67) patients (17%) had septic shock. The 28-day mortality in the combination therapy group was 10% (20 of 197) and in the monotherapy group 22% (45 of 202), adjusted HR 3.5 (95% CI (1.9–6.2), p =

Date: 2020
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0236864

DOI: 10.1371/journal.pone.0236864

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