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Table 3 Choice of empirical antimicrobial regimen according to suspected and confirmed focus of infection and compliance with recommendations (n/n (%))

From: Aetiology, antimicrobial therapy and outcome of patients with community acquired severe sepsis: a prospective study in a Norwegian university hospital

Focus of infection with recommended regimen

Suspected focus at admission Total cases/Cases with correct regimena

Confirmed focus at discharge Total cases/Cases with appropriate regimena

Respiratory b,c

100d/82 (82.0)

115d/96 (83.5)

penicillin G and ciprofloxacin or

penicillin G and gentamicin e,f

Genitourinary

25d/20 (80.0)

30d/24 (80.0)

ampicillin and gentamicin f

Soft tissue

23/18 (78.3)

27d/18 (66.7)

penicillin G and clindamycin (+/- gentamicin)

Abdominal

16d/11 (68.8)

26d/13 (50.0)

ampicillin and gentamicin and metronidazol or

3rd generation cephalosporin and metronidazol or

piperacillin-tazobactam or

meropenem

Endocarditis

4/3 (75.0)

12/7 (58.3)

penicillin G and gentamicin or

3rd generation cephalosporin

CNS

4/3 (75.0)

4/4 (100)

penicillin G and 3rd generation cephalosporin

Unknown/bacteremia

38d/34 (89.5)

5/5 (100)

penicillin G and gentamicin (+/- metronidazol)e,f

Total

210/171 (81.4)

219/167 (76.3)

  1. aCorrect and appropriate regimen according to recommendations for empirical antimicrobial therapy in Haukeland University Hospital in 2008.
  2. bOne patient with a suspected and later verified respiratory tract infection died before antimicrobial therapy was implemented.
  3. cSuspected atypical pneumonia: macrolide or doxycycline is added.
  4. dNumber of correct cases including one patient given meropenem as initial agent (n = 4 in total).
  5. eIf allergic to penicillin: clindamycin.
  6. fIf gentamicin is contraindicated: 3rd generation cephalosporin monotherapy.