Evaluation of empiric antibiotic use in surgical sepsis

Abstract Background We performed an evaluation of antimicrobial guidelines for patients with surgical sepsis. Methods The purpose of this study was to validate current empiric antibiotic recommendations in our sepsis protocol based on the suspected site of infection. The primary objective was to assess the appropriateness of empiric antibiotic recommendations and to determine if initial empiric antibiotics provided adequate coverage compared with sensitivity data (accuracy). Secondary end points included antibiotic protocol compliance, intensive care unit (ICU)-free days, and mortality. Results Appropriate antibiotics were prescribed in 82% of patients. Of the culture-positive patients, 72% received accurate antibiotics. ICU-free days were greater for patients in the compliant group (14.5 vs 8.4; P = .014). Hospital mortality was greater in patients who were noncompliant with protocol recommendations (22% vs 17%; P = .44). Conclusions Our current antibiotic guidelines provide appropriate and accurate antimicrobial coverage. Noncompliance with the antibiotic protocol resulted in fewer ICU-free days and increased hospital mortality in surgical sepsis patients.