Table 3

Antibiotic treatment patterns by infection type
Overall Diabetic foot infection Surgical site infection Deep soft tissue abscess Cellulitis
(N=1,033) (N=278) (N=330) (N=147) (N=278)
Initial intravenous antibiotics: N (%) *
 Glycopeptidesa 630 (61.0) 167 (60.1) 186 (56.4) 109 (74.1) 169 (60.4)
 Penicillinsb 386 (37.4) 141 (50.7) 101 (30.6) 53 (36.1) 91 (32.7)
 Beta-lactamase -inhibitorsc 380 (36.8) 140 (50.4) 98 (29.7) 53 (36.1) 89 (32.0)
 Beta-lactamase -resistantd 7 (0.7) 1 (0.4) 3 (0.9) 0 (0.0) 3 (1.1)
 Non-beta-lactamase inhibitorse 7 (0.7) 2 (0.7) 1 (0.3) 0 (0.0) 4 (1.4)
 Cephalosporinsf 188 (18.2) 41 (14.8) 64 (19.4) 15 (10.2) 68 (24.5)
 First-generation 90 (8.7) 13 (4.7) 37 (11.2) 3 (2.0) 37 (13.3)
 Third-generation 69 (6.7) 18 (6.5) 15 (4.5) 11 (7.5) 25 (9.0)
 Fourth-generation 27 (2.6) 9 (3.2) 13 (3.9) 0 (0.0) 5 (1.8)
 Lincosamidesj 147 (14.2) 31 (11.2) 38 (11.5) 25 (17.0) 53 (19.1)
 Fluoroquinolonesk 90 (8.7) 28 (10.1) 35 (10.6) 11 (7.5) 16 (5.8)
 Daptomycin 28 (2.7) 5 (1.8) 13 (3.9) 4 (2.7) 6 (2.2)
 Nitroimidazole derivativesm 27 (2.6) 7 (2.5) 14 (4.2) 1 (0.7) 5 (1.8)
 Other Antibiotics n 26 (2.5) 8 (2.9) 8 (2.4) 4 (2.7) 6 (2.2)
Treatment duration of the most common initial intravenous antibiotics: mean (median, minimum-maximum)
 First-generation cephalosporins 2.5 (1.7, 0–27) 1.5 (1.7, 0–3) 3.2 (1.7, 0–27) 1.6 (1.5, 0–3) 2.2 (1.5, 0–12)
 Glycopeptides 3.2 (2.6, 0–24) 3.7 (2.7, 0–24) 3.1 (2.6, 0–16) 2.8 (2.6, 0–11) 3.0 (2.7, 0–14)
 Lincosamides 2.2 (1.6, 0–10) 1.9 (1.2, 0–8) 2.5 (1.5, 0–10) 2.3 (2.3, 0–7) 2.1 (1.7, 0–9)
 Penicillins (beta-lactamase-inhibitors) 3.4 (2.6, 0–36) 3.8 (2.8, 0–24) 3.9 (2.9, 0–36) 2.4 (2.1, 0–7) 2.8 (2.4, 0–13)
Reason for administration of initial intravenous antibiotics: N (%)*
 Empiric treatment prior to culture test results 917 (88.8) 243 (87.4) 292 (88.5) 137 (93.2) 245 (88.1)
 Not responding to previous antibiotic treatment 42 (4.1) 6 (2.2) 13 (3.9) 6 (4.1) 17 (6.1)
 Other 64 (6.2) 13 (4.7) 24 (7.3) 6 (4.1) 21 (7.6)
Reason for discontinuation of initial antibiotics: N (%)* 886 232 271 136 247
 Switched to another route/formulation^ 475 (53.6) 108 (46.6) 147 (54.2) 82 (60.3) 138 (55.9)
 Infection improved, resolved, or cured^ 386 (43.6) 105 (45.3) 99 (36.5) 62 (45.6) 120 (48.6)
 Culture results indicate this antibiotic agent not needed 155 (17.5) 43 (18.5) 56 (20.7) 32 (23.5) 24 (9.7)
 Pathogen not susceptible to this antibiotic agent^ 36 (4.1) 8 (3.4) 19 (7.0) 3 (2.2) 6 (2.4)

*Not mutually exclusive.

^Percentages reported based on the number of patients who discontinued.

aIncludes vancomycin; bIncludes c, d, e below; cIncludes amoxi-clavulanico (amoxicillin, clavulanic acid), clavucar (clavulanic acid, ticarcillin), duocid (ampicillin, sulbactam), piperacillin w/tazobactam; dIncludes dicloxacillin, nafcillin, oxacillin, piperacillin; eIncludes amoxicillin, ampicillin, benzylpenicillin; fIncludes g, h, i below; gIncludes cefadroxil, cefalexin, cefazolin; hIncludes cefixime, cefotaxime, cefpodoxime, ceftazidime, ceftriaxone; iIncludes cefepime; jIncludes clindamycin; kIncludes ciprofloxacin, levofloxacin, moxifloxacin; lIncludes daptomycin, linezolid; mIncludes metronidazole; nIncludes linezolid, tigecycline, aztreonam, azithromycin, erythromycin, rifampicin, rifaximin, doxycycline, minocycline.

Lipsky et al.

Lipsky et al. BMC Infectious Diseases 2012 12:227   doi:10.1186/1471-2334-12-227

Open Data