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Longer than 2 hours to antibiotics is associated with doubling of mortality in a multinational community-acquired bacterial meningitis cohort

DP. Eisen, E. Hamilton, J. Bodilsen, R. Køster-Rasmussen, AJ. Stockdale, J. Miner, H. Nielsen, O. Dzupova, V. Sethi, RK. Copson, M. Harings, OA. Adegboye

. 2022 ; 12 (1) : 672. [pub] 20220113

Jazyk angličtina Země Velká Británie

Typ dokumentu časopisecké články, metaanalýza, práce podpořená grantem, systematický přehled

Perzistentní odkaz   https://www.medvik.cz/link/bmc22011338

To optimally define the association between time to effective antibiotic therapy and clinical outcomes in adult community-acquired bacterial meningitis. A systematic review of the literature describing the association between time to antibiotics and death or neurological impairment due to adult community-acquired bacterial meningitis was performed. A retrospective cohort, multivariable and propensity-score based analyses were performed using individual patient clinical data from Australian, Danish and United Kingdom studies. Heterogeneity of published observational study designs precluded meta-analysis of aggregate data (I2 = 90.1%, 95% CI 71.9-98.3%). Individual patient data on 659 subjects were made available for analysis. Multivariable analysis was performed on 180-362 propensity-score matched data. The risk of death (adjusted odds ratio, aOR) associated with treatment after two hours was 2.29 (95% CI 1.28-4.09) and increased substantially thereafter. Similarly, time to antibiotics of greater than three hours was associated with an increase in the occurrence of neurological impairment (aOR 1.79, 95% CI 1.03-3.14). Among patients with community-acquired bacterial meningitis, odds of mortality increase markedly when antibiotics are given later than two hours after presentation to the hospital.

Citace poskytuje Crossref.org

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