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Longer than 2 hours to antibiotics is associated with doubling of mortality in a multinational community-acquired bacterial meningitis cohort.
- Source :
-
Scientific reports [Sci Rep] 2022 Jan 13; Vol. 12 (1), pp. 672. Date of Electronic Publication: 2022 Jan 13. - Publication Year :
- 2022
-
Abstract
- To optimally define the association between time to effective antibiotic therapy and clinical outcomes in adult community-acquired bacterial meningitis. A systematic review of the literature describing the association between time to antibiotics and death or neurological impairment due to adult community-acquired bacterial meningitis was performed. A retrospective cohort, multivariable and propensity-score based analyses were performed using individual patient clinical data from Australian, Danish and United Kingdom studies. Heterogeneity of published observational study designs precluded meta-analysis of aggregate data (I <superscript>2</superscript> = 90.1%, 95% CI 71.9-98.3%). Individual patient data on 659 subjects were made available for analysis. Multivariable analysis was performed on 180-362 propensity-score matched data. The risk of death (adjusted odds ratio, aOR) associated with treatment after two hours was 2.29 (95% CI 1.28-4.09) and increased substantially thereafter. Similarly, time to antibiotics of greater than three hours was associated with an increase in the occurrence of neurological impairment (aOR 1.79, 95% CI 1.03-3.14). Among patients with community-acquired bacterial meningitis, odds of mortality increase markedly when antibiotics are given later than two hours after presentation to the hospital.<br /> (© 2022. The Author(s).)
- Subjects :
- Australia epidemiology
Community-Acquired Infections complications
Female
Humans
Male
Meningitis, Bacterial complications
Nervous System Diseases epidemiology
Nervous System Diseases etiology
Observational Studies as Topic
Propensity Score
Retrospective Studies
Sweden epidemiology
Time Factors
Treatment Outcome
United Kingdom epidemiology
Anti-Bacterial Agents administration & dosage
Community-Acquired Infections drug therapy
Community-Acquired Infections mortality
Meningitis, Bacterial drug therapy
Meningitis, Bacterial mortality
Time-to-Treatment
Subjects
Details
- Language :
- English
- ISSN :
- 2045-2322
- Volume :
- 12
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Scientific reports
- Publication Type :
- Academic Journal
- Accession number :
- 35027606
- Full Text :
- https://doi.org/10.1038/s41598-021-04349-7