| Pre-phase (N = 67, 49.6%) | Post-phase (N = 68, 50.4%) | Overall (N = 135) | p-value |
---|---|---|---|---|
Demographic data | Â | Â | Â | Â |
 Age (years), median (IQR) | 67 (55–75) | 64 (59–75) | 67 (58–75) | 0.85 |
 Sex, male | 23 (34.3) | 20 (29.4) | 43 (31.9) | 0.58 |
Baseline characteristics | Â | Â | Â | Â |
 MDR colonization | 19 (28.4) | 17 (25.0) | 36 (26.7) | 0.70 |
 Immunosuppression | 13 (19.4) | 20 (29.4) | 33 (24.4) | 0.23 |
 Charlson comorbidity index, median (IQR) | 5 (3–7) | 5 (4–7) | 5 (3–7) | 0.19 |
Infection characteristics | Â | Â | Â | Â |
 Septic shock | 41 (61.2) | 47 (69.1) | 88 (65.2) | 0.22 |
 CRRT | 29 (43.3) | 24 (35.3) | 53 (39.3) | 0.38 |
 MV | 43 (64.2) | 49 (72.1) | 92 (68.1) | 0.36 |
 Baseline SOFA score | 8 (6–9) | 10 (6–14) | 8 (6–11) | 0.02 |
 Pitt score | 2 (0–6) | 2 (0–3) | 2 (0–4) | 0.06 |
BSI characteristics | Â | Â | Â | Â |
 Community-acquired | 9 (13.4) | 7 (10.3) | 16 (11.9) | 0.05 |
 Healthcare-related | 11 (16.4) | 3 (4.4) | 14 (10.4) |  |
 Hospital-acquired | 47 (70.1) | 58 (85.3) | 105 (77.8) |  |
 Primary | 10 (14.9) | 13 (19.1) | 23 (17.0) | 0.32 |
 Secondary | 48 (73.8) | 50 (73.5) | 98 (72.6) | 0.03 |
  Intra-abdominal | 27 (56.3) | 18 (36) | 45 (45.9) |  |
  LRTI | 11 (22.9) | 23 (46.0) | 34 (34.7) |  |
  UTI | 8 (16.7) | 9 (18.0) | 17 (17.3) |  |
  Other | 2 (4.2) | 0 (0) | 2 (2.0) |  |
 Device-related | 9 (13.8) | 5 (7.4) | 14 (10.4) |  |
 ICU admission to BSI onset (days) (median, IQR) | 4 (1–14) | 2 (0–13) | 2 (0–13) | 0.26 |
Management of BSI | Â | Â | Â | Â |
 FUBC | 40 (59.7) | 66 (97.1) | 106 (78.5) | < 0.001 |
  Negative FUBC | 25 (62.5) | 65 (95.6) | 90 (83.3) | < 0.001 |
 SC performed | 9 (1.2) | 5 (1.4) | 14 (10.3) | 0.11 |
 SC not performed | 13 (19.4) | 7 (10.3) | 20 (14.8) |  |
 SC not applicable | 29 (43.3) | 41 (60.3) | 70 (51.9) |  |
Antibiotic management | Â | Â | Â | Â |
 Empirical cephalosporin | 4 (6.0) | 8 (11.9) | 12 (9.0) | 0.37 |
 Empirical BL/BLI | 13 (19.4) | 29 (43.3) | 42 (31.3) | 0.005 |
 Empirical carbapenem | 42 (62.7) | 27 (40.3) | 69 (51.5) | 0.02 |
 Appropriate empirical therapy | 37 (55.2) | 59 (86.9) | 96 (71.1) | < 0.001 |
 Targeted cephalosporin | 5 (7.6) | 16 (23.5) | 21 (15.6) | 0.001 |
 Targeted BL/BLI | 9 (13.6) | 18 (26.5) | 27 (20.1) | 0.08 |
 Targeted novel BL/BLI | 14 (20.9) | 10 (14.7) | 28 (17.8) | 0.23 |
 Targeted carbapenem | 37 (56.1) | 29 (42.6) | 66 (49.3) | 0.17 |
 Targeted escalation | 3 (4.5) | 2 (2.9) | 5 (3.7) | 0.98 |
 Targeted de-escalation | 8 (11.9) | 14 (20.6) | 22 (16.3) | 0.56 |
 Days of appropriate therapy (median, IQR) | 16 (12–20) | 12 (9–15) | 14 (11–17) | < 0.001 |
 Css/MIC ratio > 4 at 48 h from B-lactam start | - | 68 (100) |  |  |
 Css/MIC ratio > 4 at 7 days from B-lactam start | - | 68 (100) |  |  |
Dosing reduction after first TDM assessment | - | 43 (63.2) | Â | Â |
Overall piperacillin/tazobactam DDD/patient | 105 | 168 | 273 | 0.002 |
Median piperacillin/tazobactam DDD/patient | 2 (2–12) | 3 (2–6) | 3 (2–7) | 0.78 |
Overall meropenem DDD/patient | 585 | 232 | 814 | < 0.001 |
Median meropenem DDD/patient | 15 (11–19) | 7 (3–10) | 11 (7–17) | < 0.001 |
Outcomes | Â | Â | Â | Â |
 SOFA 48 h | 7 (5–9) | 8 (5–14) | 7 (5–10) | 0.15 |
 Delta SOFA 0-48 h | 1 (-1-2) | 1 (0–2) | 1 (0–2) | 0.57 |
 SOFA score 7 days | 4 (1–7) | 6 (3–10) | 5 (2–8) | 0.002 |
 Delta SOFA 0-7days | 2 (0–4) | 3 (1–6) | 2 (1–5) | 0.26 |
 Clinical cure | 31 (47.7) | 51 (75.0) | 82 (61.7) | 0.001 |
 Microbiological failure | 20 (29.9) | 7 (10.3) | 27 (20.0) | 0.005 |
Persistent BSI | 11 (16.4) | 3 (4.4) | 14 (10.4) | 0.03 |
Breakthrough BSI | 10 (14.9) | 4 (5.9) | 14 (10.4) | 0.09 |
Recurrent BSI | 12 (17.9) | 5 (7.4) | 17 (12.6) | 0.07 |
MDRO colonization 30-day | 23 (53.5) | 6 (12.5) | 29 (31.9) | < 0.001 |
New MDRO colonization 30-day | 15 (36.6) | 4 (8.3) | 19 (21.3) | 0.002 |
MDRO colonization 90-day | 13 (36.1) | 4 (9.8) | 17 (22.1) | 0.007 |
C. difficile infection 30-day | 1 (2.6) | 2 (4.2) | 3 (3.5) | 1 |
All-cause 30-day mortality | 24 (35.8) | 24 (35.3) | 48 (35.6) | 1 |
All-cause 90-day mortality | 7 (17.1) | 3 (6.8) | 10 (11.8) | 0.19 |
Length of hospital stay | 42 (24–64) | 43 (27–64) | 43 (26–64) | 0.46 |
Length of ICU stay | 21 (7–36) | 18 (6–34) | 18 (7–35) | 0.41 |