meropenem and Mediastinitis

Inappropriate use of broad-spectrum antimicrobials affects adversely both the individual patient and the general public. The aim of the study was to identify patients at risk for excessively prolonged carbapenem treatment in the ICU as a target for antimicrobial stewardship interventions.. Case-control study in a network of 11 ICUs of a university hospital. Patients with uninterrupted meropenem therapy (MT) > 4 weeks were compared to controls. Controls were defined as patients who stayed on the ICU > 4 weeks and received meropenem for ≤ 2 weeks. Associations between case-control status and potential risk factors were determined in a multivariate logistic regression model.. Between 1. Surgical patients with peritonitis and patients with known colonization with MDR Gram-negative bacteria are at risk for excessively prolonged carbapenem therapy and represent an important target population for antimicrobial stewardship interventions.

Topics: Aged; Anti-Bacterial Agents; Case-Control Studies; Drug Resistance, Multiple, Bacterial; Female; Gram-Negative Bacterial Infections; Humans; Intensive Care Units; Length of Stay; Male; Mediastinitis; Meropenem; Middle Aged; Odds Ratio; Peritonitis; Pneumonia; Risk Factors; Thienamycins; Time Factors

Topics: Anti-Bacterial Agents; Humans; Hypoplastic Left Heart Syndrome; Infant, Newborn; Mediastinitis; Meropenem; Negative-Pressure Wound Therapy; Norwood Procedures; Sternotomy; Surgical Wound Infection; Thienamycins

Topics: Aged, 80 and over; Air Pressure; Anti-Bacterial Agents; Axilla; Equipment Design; Fatal Outcome; Fever; Humans; Laryngeal Masks; Lymph Node Excision; Male; Mediastinitis; Meropenem; Pharynx; Spondylitis, Ankylosing; Subcutaneous Emphysema; Thienamycins