Carbapenem is not always the best choice in the treatment of septic shock

Abstract

Background: Septic shock is a global public health burden. In addition to the improvement of the level of individual care, the improvement of the overall hospital quality control management is also an essential key aspect of the Surviving Sepsis Campaign (SSC). Using of antibiotics is a cornerstone in the treatment of septic shock, so we conducted this study to investigate the influence of antibiotics and pathogenic bacteria on the mortality of septic shock at the level of overall hospital in China.

Methods: This was an observational database study in 2021 enrolled the data of 787 hospitals from 31 provinces/municipalities/autonomous regions of Mainland China collected in a survey from January 1, 2021 to December 31, 2021.

Results: The proportion of ICU patients with septic shock was 3.55%, while the patient mortality of septic shock was 23.08%. While carbapenem was the most preferred antibiotic medication used in 459 of the 782 hospitals, the preference for carbapenem did not show significant effect on the patient mortality in the treatment of septic shock (p-value 0.59). Compared with patients with fermenting bacteria as the most common pathogenic bacteria causing septic shock, patients with non-fermenting bacteria had a higher mortality (p-value 0.01).

Conclusions: Whether using carbapenem as the preferred antibiotic or not, did not show effect on the patient mortality of septic shock. Compared with patients with fermenting bacteria as the most common pathogenic bacteria, patients of septic shock with non-fermenting bacteria had a higher mortality.

Keywords: Carbapenem; Fermenting bacteria; Hospital management; Mortality; Septic shock.

Fig. 1

Patient mortality of septic shock

Fig. 2

Effects of antibiotics and pathogenic bacteria on the patient mortality of septic shock. With carbapenem using carbapenem as the preferred antibiotic medication, without carbapenem not using carbapenem as the preferred antibiotic medication. Non-fermenting detecting non-fermenting bacteria as the most common pathogenic bacteria causing septic shock, fermenting detecting fermenting bacteria as the most common pathogenic bacteria causing septic shock

Fig. 3

Effects of antibiotics and pathogenic bacteria on the patient mortality of septic shock. With carbapenem using carbapenem as the preferred antibiotic medication, without carbapenem not using carbapenem as the preferred antibiotic medication. Non-fermenting detecting non-fermenting bacteria as the most common pathogenic bacteria causing septic shock, fermenting detecting fermenting bacteria as the most common pathogenic bacteria causing septic shock.* p < 0.05, compared with the Non-fermenting group.