The benefit of appropriate empirical antibiotic treatment in patients with bloodstream infection

. Leibovici L, Shraga I, Drucker M, Konigsberger H, Samra Z, Pitlik SD (Rabin Medical Center, Petah‐Tiqva, and Tel‐Aviv University, Tel‐Aviv, Israel). The benefit of appropriate empirical antibiotic treatment in patients with bloodstream infection. J Intern Med 1998; 244: 379–86. Objectives To test whether empirical antibiotic treatment that matches the in vitro susceptibility of the pathogen (appropriate treatment) improves survival in patients with bloodstream infections; and to measure the improvement. Design Observational, prospective cohort study. Setting University hospital in Israel. Subjects All patients with bloodstream infections detected during 1988–94. Interventions None. Main outcome measures In‐hospital fatality rate and length of hospitalization. Results Out of 2158 patients given appropriate empirical antibiotic treatment, 436 (20%) died, compared with 432 of 1255 patients (34%) given inappropriate treatment (P = 0.0001). The median durations of hospital stay for patients who survived were 9 days for patients given appropriate treatment and 11 days for patients given inappropriate treatment. For patients who died, the median durations were 5 and 4 days, respectively (P