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The Time Course of Catecholamine Dose Reduction in Septic Shock as a Predictor of Bacterial Susceptibility to Empiric Antimicrobial Therapy: A Retrospective Observational Study
Version 1
: Received: 7 September 2024 / Approved: 9 September 2024 / Online: 9 September 2024 (12:37:01 CEST)
How to cite:
Kuwana, T.; Kinoshita, K.; Yamaya, Y.; Takahashi, K.; Yamaguchi, J.; Sakurai, A.; Imai, A. T. The Time Course of Catecholamine Dose Reduction in Septic Shock as a Predictor of Bacterial Susceptibility to Empiric Antimicrobial Therapy: A Retrospective Observational Study. Preprints2024, 2024090603. https://doi.org/10.20944/preprints202409.0603.v1
Kuwana, T.; Kinoshita, K.; Yamaya, Y.; Takahashi, K.; Yamaguchi, J.; Sakurai, A.; Imai, A. T. The Time Course of Catecholamine Dose Reduction in Septic Shock as a Predictor of Bacterial Susceptibility to Empiric Antimicrobial Therapy: A Retrospective Observational Study. Preprints 2024, 2024090603. https://doi.org/10.20944/preprints202409.0603.v1
Kuwana, T.; Kinoshita, K.; Yamaya, Y.; Takahashi, K.; Yamaguchi, J.; Sakurai, A.; Imai, A. T. The Time Course of Catecholamine Dose Reduction in Septic Shock as a Predictor of Bacterial Susceptibility to Empiric Antimicrobial Therapy: A Retrospective Observational Study. Preprints2024, 2024090603. https://doi.org/10.20944/preprints202409.0603.v1
APA Style
Kuwana, T., Kinoshita, K., Yamaya, Y., Takahashi, K., Yamaguchi, J., Sakurai, A., & Imai, A. T. (2024). The Time Course of Catecholamine Dose Reduction in Septic Shock as a Predictor of Bacterial Susceptibility to Empiric Antimicrobial Therapy: A Retrospective Observational Study. Preprints. https://doi.org/10.20944/preprints202409.0603.v1
Chicago/Turabian Style
Kuwana, T., Atsushi Sakurai and and Toru Imai. 2024 "The Time Course of Catecholamine Dose Reduction in Septic Shock as a Predictor of Bacterial Susceptibility to Empiric Antimicrobial Therapy: A Retrospective Observational Study" Preprints. https://doi.org/10.20944/preprints202409.0603.v1
Abstract
Background/Objectives: The 28-day mortality rate for septic shock is high, necessitating rapid and effective empiric antimicrobial therapy. This study investigates whether the rate of catecholamine dose reduction in septic shock can indicate bacterial susceptibility to initial antimicrobial therapy. Methods: This retrospective observational study involved 108 adult patients with bacteraemia and septic shock admitted at the intensive care unit of Nihon University Itabashi Hospital between January 2017 and December 2023. They were classified into the Susceptible or Resistant group based on the bacteria’s susceptibility to the initial empiric antimicrobial therapy. Catecholamine dosages were converted to norepinephrine equivalent (NEE) scores, with the time course from peak to end of administration measured at NEE reductions. Results: Of the 108 patients, 94 were in the Susceptible group and 14 in the Resistant group. The Susceptible group showed faster reductions in catecholamine doses: time to reduce the dose from the maximum NEE to 25% was 19 vs. 49.5 hours (p = 0.0057); and 0%, 29 vs. 54 hours (p = 0.0475). Conclusions: In septic shock with bacteraemia, faster catecholamine dose reduction indicates bacterial susceptibility to initial empiric antibiotics. This reduction rate can serve as an early clinical indicator of appropriate initial empiric therapy.
Keywords
antimicrobial susceptibility; catecholamines; early indicator; norepinephrine equivalent (NEE); septic shock
Subject
Medicine and Pharmacology, Emergency Medicine
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.