1

Kumar et al, Chest 2009; 136:1237–1248

survival (%)0 20 40 60

non-albicans yeast

C. albicans

Ps. aeruginosa

Enterobacter sp

Klebsiella sp

E. coli

other Strep sp

Enterococcus sp

S. pneumoniae

S. aureus

inappropriateappropriate

153

290

295

148

869

312

n p value

odds ratio0.1 1 10 100

268

181

284

597

.0002

<.0001

<.0001

.0002

<.0001

<.0001

.0005

<.0001

.0101

<.0001

2

Impact of Appropriateness of Initial Antimicrobial Therapy on Survival from Septic Shock

percent (%)

0 20 40 60 80 100

lcbi

cri

uti

sst

IAI

pneu

nosocomial

community

bacteremia -

bacteremia +

culture -

culture +

all

%survival% appropriate

survival (%)

0 10 20 30 40 50 60 70 80

lcbi

cri

uti

sst

IAI

pneu

nosocomial

community

bacteremia -

bacteremia +

culture -

culture +

all

inappropriateappropriate

Kumar et al, Chest 2009; 136:1237–1248

5

Impact of Appropriateness of Initial Antimicrobial Therapy on Survival from Septic Shock

survival (%)

0 10 20 30 40 50 60 70 80

lcbi

cri

uti

sst

IAI

pneu

nosocomial

community

bacteremia -

bacteremia +

culture -

culture +

all

inappropriateappropriate

Kumar et al, Chest 2009; 136:1237–1248Odds Ratio

1 10 100 1000

236

205

499

344

1041

1381

1912

2144

2044

2013

1659

4056

5715

<.0001

<.0001

<.0001

<.0001

<.0001

<.0001

<.0001

<.0001

<.0001

<.0001

<.0001

<.0001

<.0001

n p value

6

Kumar et al, Chest 2009; 136:1237–1248

survival (%)0 20 40 60

nosocomial

community

bacteremia -

bacteremia +

culture -

culture +

all

inappropriateappropriate

2144

2044

2013

1659

1912

5715

4056

n

<.0001

<.0001

<.0001

<.0001

<.0001

<.0001

<.0001

p value

odds ratio1 10 100

7

Kumar et al, Chest 2009; 136:1237–1248

survival (%)0 20 40 60 80

pbi

cri

uti

sst

IAI

pneu

inappropriateappropriate

236

205

499

344

1381

1041

n

<.0001

<.0001

<.0001

<.0001

<.0001

<.0001

p value

odds ratio1 10 100

8

Kumar et al, Chest 2009; 136:1237–1248

survival (%)0 20 40 60

non-albicans yeast

C. albicans

Ps. aeruginosa

Enterobacter sp

Klebsiella sp

E. coli

other Strep sp

Enterococcus sp

S. pneumoniae

S. aureus

inappropriateappropriate

153

290

295

148

869

312

n p value

odds ratio0.1 1 10 100

268

181

284

597

.0002

<.0001

<.0001

.0002

<.0001

<.0001

.0005

<.0001

.0101

<.0001

9

Kumar et al, Chest 2009; 136:1237–1248

survival (%)0 20 40 60

yeast

anaerobes

g-b

g+c

inappropriateappropriate

443

156

2002

1355

n p value

odds ratio1 10 100

<.0001

.0048

<.0001

<.0001

10

Kumar et al, Chest 2009; 136:1237–1248

survival (%)

0 10 20 30 40 50 60 70 80

lcbi

cri

uti

sst

IAI

pneu

nosocomial

community

bacteremia -

bacteremia +

culture -

culture +

all

inappropriateappropriate

survival (%)

0 10 20 30 40 50 60 70

non-albicans

C. albicans

Ps. aeruginosa

Enterobacter sp

Klebsiella sp

E. coli

other Strep sp

Enterococcus sp

S. pneumoniae

S. aureus

yeast

anaerobes

g-b

g+c

inappropriateappropriate

11

Kumar et al, Chest 2009; 136:1237–1248

percent (%)

0 20 40 60 80 100

lcbi

cri

uti

sst

IAI

pneu

nosocomial

community

bacteremia -

bacteremia +

culture -

culture +

all

%survival% appropriate

percent (%)

0 20 40 60 80 100

non-albicans

C. albicans

Ps. aeruginosa

Enterobacter sp

Klebsiella sp

E. coli

other Strep sp

Enterococcus sp

S. pneumoniae

S. aureus

yeast

anaerobes

g-b

g+c

% survival% appropriate