Managing adult patients with infectious diseases in emergency departments: international ID-IRI study

Erdem H. Hargreaves S. Ankarali H. Caskurlu H. Ceviker S.A. Bahar-Kacmaz A. Meric-Koc M. Altindis M. Yildiz-Kirazaldi Y. Kizilates F. Alsalman J. Cag Y. Kamal A.H.M. Dokmetas I. Dindar-Demiray E.K. Shehata G.A. Hasman H. Sadykova A. Llopis F. Ramosaco E. Logar M. Alay H. Kesmez-Can F. Ruch Y. Bulut D. Makek M.J. Marino A. Mahboob A. El-Kholy A. Abdallah D. Sefa-Sayar M. Karaali R. Aslan S. Dar R.E. Abdalla E. Monzón-Camps H. Baljić R. Mgdalena D.I. Naghili B. Abbas Dafalla M.E. Alwashmi A.S.S. Carmen C.R. Ramirez-Estrada S. Wojewodzka-Zelezniakowicz M. Akyildiz O. Zajkowska J. El-Sokkary R. Pandya N. Amer F. Alavi-Darazam I. Grgić S. Wegdan A.A. El-Kholy J. Bulut-Avsar C. Kulzhanova S. Tasbakan M. Kumari H.P. Dirani N. Koganti K. Konkayev A.K. Petrov M.M. Cascio A. Liskova A. Del Vecchio R.F. Lambertenghi L. Mladenov N. Oncu S. Rello J.
2021 Taylor and Francis Ltd.

Journal of Chemotherapy
2021 #33 Issue 5 302 - 318 pp.

We aimed to explore factors for optimizing antimicrobial treatment in emergency departments. A single-day point prevalence survey was conducted on January 18, 2020, in 53 referral/tertiary hospitals in 22 countries. 1957 (17%) of 11557 patients presenting to EDs had infections. The mean qSOFA score was 0.37 ± 0.74. Sepsis (qSOFA ≥ 2) was recorded in 218 (11.1%) patients. The mean qSOFA score was significantly higher in low-middle (1.48 ± 0.963) compared to upper-middle (0.17 ± 0.482) and high-income (0.36 ± 0.714) countries (P < 0.001). Eight (3.7%) patients with sepsis were treated as outpatients. The most common diagnoses were upper-respiratory (n = 877, 43.3%), lower-respiratory (n = 316, 16.1%), and lower-urinary (n = 201, 10.3%) infections. 1085 (55.4%) patients received antibiotics. The most-commonly used antibiotics were beta-lactam (BL) and BL inhibitors (n = 307, 15.7%), third-generation cephalosporins (n = 251, 12.8%), and quinolones (n = 204, 10.5%). Irrational antibiotic use and inappropriate hospitalization decisions seemed possible. Patients were more septic in countries with limited resources. Hence, a better organizational scheme is required.

antibiotic , elderly , Emergency , infection , sepsis , treatment

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ID-IRI, Ankara, Turkey
Institute for Infection and Immunity, St Georges University of London, London, United Kingdom
Department of Biostatistics and Medical Informatics, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
Department of Infectious Diseases and Clinical Microbiology, Kutahya Evliya Celebi Research and Education Hospital, Kutahya, Turkey
Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University, Istanbul, Turkey
Department of Medical Microbiology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
Department of Emergency Medicine, Sakarya Training and Research Hospital, Sakarya, Turkey
Department of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, Health Sciences University, Antalya, Turkey
Salmaniya Medical Complex, Manama, Bahrain
Rajshahi Medical College Hospital, Rajshahi, Bangladesh
Department of Infectious Diseases and Clinical Microbiology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
Department of Infectious Diseases and Clinical Microbiology, Bitlis Public Hospital, Bitlis, Turkey
Department of Neurology, Assiut University, Assiut, Egypt
Emergency Department, Ankara Medicalpark Hospital, Ankara, Turkey
Department of Infectious and Tropical Diseases, City Clinical Infectious Hospital, Kazakh National Medical University, Almaty, Kazakhstan
Emergency Department, Hospital Universitari de Bellvitge, Barcelona, Spain
Infectious Diseases Clinic, University Hospital Center “Mother Teresa”, Tirana, Albania
Department of Infectious Diseases, UMC Ljubljana, Ljubljana, Slovenia
Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
Department of Infectious Diseases, Strasbourg University Hospital, Strasbourg, France
Department of Infectious Diseases and Clinical Microbiology, Van Training and Research Hospital, Van, Turkey
School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia
Department of Infectious Diseases, ARNAS Garibaldi Hospital, University of Catania, Catania, Italy
Bacha Khan Medical Complex Swabi, Khyber Pakhtunkhwa, Pakistan
Faculty of Medicine, Cairo University, Giza, Egypt
Department of Intensive Care, Prime Hospital, Dubai, United Arab Emirates
Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa School of Medicine, İstanbul Üniversitesi, Istanbul, Turkey
Department of Infectious Diseases and Clinical Microbiology, Cengiz Gokcek Maternity and Childrens Hospital, Gaziantep, Turkey
Department of Internal Medicine, Rambam Health Care Campus, Haifa, Israel
Department of Anesthesia & ICU, Assiut University Hospital, Assiut, Egypt
Emergency Department and Infectious Diseases, Hospital Universitary Mútua Terrassa, Terrassa, Spain
Clinic for Infectious Diseases, Sarajevo, Bosnia and Herzegovina
Clinical Infectious Diseases Hospital, Ovidius University of Constanta, Constanta, Romania
Department of Infectious Diseases, Imam Reza Hospital, Tabriz, Iran
Department of Emergency Medicine, King Fahad Specialist Hospital, Al-Qassim, Saudi Arabia
Medical Laboratories Department, College of Applied Medical Sciences, Qassim University, Saudi Arabia
Clinical Hospital for Infectious Diseases, Ovidius University Constanta, Constanta, Romania
Intensive Care Department, Clínica Corachan, Barcelona, Spain
University Teaching Hospital, Bialystok, Poland
Department of Infectious Diseases and Clinical Microbiology, Adana Acibadem Hospital, Adana, Turkey
Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Bhailal Amin General Hospital, Vadodara, India
Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Department of Infectious Diseases and Tropical Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Clinic for Infectious Disease, University Hospital Mostar, Mostar, Bosnia and Herzegovina
Fayoum Faculty of Medicine, Fayoum University, Fayoum, Egypt
Faculty of Medicine, Cairo University, Cairo, Egypt
Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Ege University, Izmir, Turkey
Department of Infectious Diseases, Astana Medical University, Nur-Sultan, Kazakhstan
GITAM Institute of Medical Sciences and Research, Visakhatpatnam, India
Dar Al Amal University Hospital, Douris, Lebanon
SHRI, Rajasthan, India
Institution of Trauma and Orthopaedics, Astana Medical University, Nur-Sultan, Kazakhstan
Department of Microbiology and Immunology, Faculty of Pharmacy, Medical University, Plovdiv, Bulgaria
Infectious and Tropical Diseases Section, Department PROMISE, University of Palermo, Palermo, Italy
Hospital Nitra, Nitra, Slovakia
Department of Infectious Diseases, Umberto I Hospital, Siracusa, Italy
Policlinico G.B. Rossi - AOUI Verona, Verona, Italy
St Marina University Hospital, Varna, Bulgaria
Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Adnan Menderes University, Aydin, Turkey
Critical Care Department, Hospital Vall d’Hebron, Barcelona, Spain
CIBERES, Madrid, Spain
Universitat Autonma de Barcelona, Barcelona, Spain

ID-IRI
Institute for Infection and Immunity
Department of Biostatistics and Medical Informatics
Department of Infectious Diseases and Clinical Microbiology
Department of Infectious Diseases and Clinical Microbiology
Department of Infectious Diseases and Clinical Microbiology
Department of Medical Microbiology
Department of Emergency Medicine
Department of Infectious Diseases and Clinical Microbiology
Salmaniya Medical Complex
Rajshahi Medical College Hospital
Department of Infectious Diseases and Clinical Microbiology
Department of Infectious Diseases and Clinical Microbiology
Department of Neurology
Emergency Department
Department of Infectious and Tropical Diseases
Emergency Department
Infectious Diseases Clinic
Department of Infectious Diseases
Department of Infectious Diseases and Clinical Microbiology
Department of Infectious Diseases
Department of Infectious Diseases and Clinical Microbiology
School of Medicine
Department of Infectious Diseases
Bacha Khan Medical Complex Swabi
Faculty of Medicine
Department of Intensive Care
Department of Infectious Diseases and Clinical Microbiology
Department of Infectious Diseases and Clinical Microbiology
Department of Internal Medicine
Department of Anesthesia & ICU
Emergency Department and Infectious Diseases
Clinic for Infectious Diseases
Clinical Infectious Diseases Hospital
Department of Infectious Diseases
Department of Emergency Medicine
Medical Laboratories Department
Clinical Hospital for Infectious Diseases
Intensive Care Department
University Teaching Hospital
Department of Infectious Diseases and Clinical Microbiology
Medical Microbiology and Immunology Department
Bhailal Amin General Hospital
Department of Medical Microbiology and Immunology
Department of Infectious Diseases and Tropical Medicine
Clinic for Infectious Disease
Fayoum Faculty of Medicine
Faculty of Medicine
Department of Infectious Diseases and Clinical Microbiology
Department of Infectious Diseases
GITAM Institute of Medical Sciences and Research
Dar Al Amal University Hospital
SHRI
Institution of Trauma and Orthopaedics
Department of Microbiology and Immunology
Infectious and Tropical Diseases Section
Hospital Nitra
Department of Infectious Diseases
Policlinico G.B. Rossi - AOUI Verona
St Marina University Hospital
Department of Infectious Diseases and Clinical Microbiology
Critical Care Department
CIBERES
Universitat Autonma de Barcelona

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