{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T21:01:43Z","timestamp":1760043703633},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","license":[{"start":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T00:00:00Z","timestamp":1688515200000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Our aim in this retrospective cohort study was to assess the impact on mortality of the empirical use of polymyxin as therapy for carbapenem-resistant gram-negative bacteria (CR-GNB) in septic patients. The study was performed at a tertiary academic hospital in Brazil, from January 2018 to January 2020, the pre\u2013coronavirus disease 2019 period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We included 203 patients with suspected sepsis. The first doses of antibiotics were prescribed from a \u201csepsis antibiotic kit\u201d, which contained a selection of drugs, including polymyxin, with no preapproval policy. We developed a logistic regression model to assess risk factors associated with 14-day crude mortality. Propensity score for polymyxin was used to control biases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Seventy (34%) of 203 patients had infections with at least 1 multidrug-resistant organism isolated from any clinical culture. Polymyxins in monotherapy or in combination therapy were prescribed to 140 of the 203 (69%) patients. The overall 14-day mortality rate was 30%. The 14-day crude mortality was associated with age (adjusted odds ratio [aOR], 1.03; 95% confidence interval [CI], 1.01\u20131.05; P = .01), SOFA (sepsis-related organ failure assessment) score value (aOR, 1.2; 95% CI, 1.09\u20131.32; P &amp;lt; .001), CR-GNB infection (aOR, 3.94; 95% CI, 1.53\u201310.14; P = .005), and time between suspected sepsis and antibiotic administration (aOR, 0.73; 95% CI, .65\u2013.83; P &amp;lt; .001). The empirical use of polymyxins was not associated with decreased crude mortality (aOR, 0.71; 95% CI, .29\u20131.71; P = .44).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Empirical use of polymyxin for septic patients in a setting with high CR-GNB prevalence was not associated with decreased crude mortality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciad272","type":"journal-article","created":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T19:38:53Z","timestamp":1688585933000},"page":"S62-S69","source":"Crossref","is-referenced-by-count":2,"title":["Crude Mortality Associated With the Empirical Use of Polymyxins in Septic Patients in a Setting of High Prevalence of Carbapenem-Resistant Gram-negative Bacteria: Retrospective Analysis of a Cohort"],"prefix":"10.1093","volume":"77","author":[{"given":"Camila L P A M","family":"Bezerra","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Hospital das Cl\u00ednicas, Universidade de S\u00e3o Paulo , S\u00e3o Paulo , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Eus\u00e9bio L","family":"dos Santos","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hospital das Cl\u00ednicas, Universidade de S\u00e3o Paulo , S\u00e3o Paulo , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maura S","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Infection Control Department, Hospital das Cl\u00ednicas, Universidade de S\u00e3o Paulo , S\u00e3o Paulo , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Beatriz S","family":"Dias","sequence":"additional","affiliation":[{"name":"Infection Control Department, Hospital das Cl\u00ednicas, Universidade de S\u00e3o Paulo , S\u00e3o Paulo , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna S","family":"Levin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hospital das Cl\u00ednicas, Universidade de S\u00e3o Paulo , S\u00e3o Paulo , Brazil"},{"name":"Department of Infectious Diseases, Faculdade de Medicina, Universidade de S\u00e3o Paulo , S\u00e3o Paulo , Brazil"},{"name":"Faculdade de Medicina, Universidade de S\u00e3o Paulo , S\u00e3o Paulo , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maristela P","family":"Freire","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hospital das Cl\u00ednicas, Universidade de S\u00e3o Paulo , S\u00e3o Paulo , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Icaro","family":"Boszczowski","sequence":"additional","affiliation":[{"name":"Infection Control Department, Hospital das Cl\u00ednicas, Universidade de S\u00e3o Paulo , S\u00e3o Paulo , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matias C","family":"Salom\u00e3o","sequence":"additional","affiliation":[{"name":"Infection Control Department, Hospital das Cl\u00ednicas, Universidade de S\u00e3o Paulo , S\u00e3o Paulo , Brazil"},{"name":"Department of Infectious Diseases, Faculdade de Medicina, Universidade de S\u00e3o Paulo , S\u00e3o Paulo , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,7,5]]},"reference":[{"key":"2023070517371793800_ciad272-B1","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/S0140-6736(19)32989-7","article-title":"Global, regional, and national sepsis incidence and mortality, 1990\u20132017: analysis for the Global Burden of Disease Study","volume":"395","author":"Rudd","year":"2020","journal-title":"Lancet"},{"key":"2023070517371793800_ciad272-B2","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA"},{"key":"2023070517371793800_ciad272-B3","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1001\/jama.2016.0289","article-title":"Sepsis Definitions Task Force. 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