Prophylactic antibiotic treatment in severe acute ischemic stroke: the A ntimicrobial chemop R rophylaxis for I schemic ST rok E I n Mace D on I a –Thrace S tudy (ARISTEIDIS)

AbstractInfections represent a leading cause of mortality in patients with acute ischemic stroke, but it is unclear whether prophylactic antibiotic treatment improves the outcome. We aimed to evaluate the effects of this treatment on infection incidence and short-term mortality. This was a pragmatic, prospective multicenter real-world analysis of previously independent consecutive patients with acute ischemic stroke who were>18  years, and who had at admission National Institutes of Health Stroke Scale (NIHSS)>11. Patients with infection at admission or during the preceding month, with axillary temperature at admission>37  °C, with chronic inflammatory diseases or under treatment with corticosteroids were excluded from the study. Among 110 patients (44.5 % males, 80.2 ± 6.8 years), 31 (28.2 %) received prophylactic antibiotic treatment, mostly cefuroxime (n = 21). Prophylactic antibiotic treatment was administered to 51.4 % of patients who developed infection, and to 16.4 % of patients who did not (p <  0.001). Independent predictors of infection were NIHSS at admission [relative risk (RR) 1.16, 95 % confidence interval (CI) 1.08–1.26,p <  0.001] and prophylactic antibiotic treatment (RR 5.84, 95 % CI 2.03–16.79,p <  0.001). The proportion of patients who received prophylactic antibiotic treatment did not differ between patients who died during hospitalization and those discharged, or between patients who died during hospitalization ...
Source: Internal and Emergency Medicine - Category: Emergency Medicine Source Type: research