PMID- 18414358
OWN - NLM
STAT- MEDLINE
DCOM- 20080819
LR  - 20161124
IS  - 1827-1596 (Electronic)
IS  - 0375-9393 (Linking)
VI  - 74
IP  - 5
DP  - 2008 May
TI  - Italy versus the United Kingdom: differing styles for treating bacteremia in the 
      critically ill patient, but who's right?
PG  - 155-61; quiz 162-3
AB  - BACKGROUND: As no prospective, randomized, clinical trials (PRCTs) exist to 
      inform decisions about antibiotic therapy for bacteraemia, ICUs have likely 
      developed their own strategies. A multi-centre, multi-national questionnaire 
      survey was used to assess variations in antibiotic strategy between ICUs in the 
      United Kingdom (UK) and Italy. METHODS: In January 2001, a detailed questionnaire 
      regarding antibiotic policy was sent to international (e.g., European Society of 
      Intensive Care Medicine, ESICM) and national societies (Gruppo Italiano per la 
      Valutazione degli Interventi in Terapia Intensiva, GIVITI; Australia and New 
      Zealand Intensive Care-Critical Trial Group, ANZIC-CTG; United Kingdom-Intensive 
      Care Society, UK-ICS). RESULTS: Out of the 254 participating ICUs, 81 were from 
      Italy and 32 were from the UK. In the UK, ICUs preferred to use a shorter course 
      of mono-therapy compared to Italian ICUs when treating, a) primary bacteremia [7 
      (5-7) vs 10 (7-14), P<0.001]; b) UTI [5 (4-7) vs 8 (7-10), P<0.001]; c) 
      Staphylococcus aureus [7 (5-12) vs 10 (7-15), P<0.001]; and d) Gram-negative 
      bacteraemia associated with lines [6 (5-7) vs 10 (7-15), P<0.001], pneumonia [7 
      (5-7) vs 14 (10-15), P<0.001] and peritonitis [7 (5-9) vs 15 (10-15), P<0.000]. 
      These differences in treatment strategy were likely correlated with the median 
      inter-quartile range (IQR) of weekly input from a microbiologist or infectious 
      disease specialist, which was more frequent in the UK compared to Italy [5 (2-6) 
      vs 0 (0-1), P<0.001]. CONCLUSION: Possible influences accounting for the 
      variations found between Italy and the UK are: 1) differences in interactions 
      with microbiologists or infectious disease specialists, 2) historical/educational 
      dogma, and 3) antibiotic resistance patterns. Further studies are necessary to 
      determine the optimal approach to treating bacteremia.
FAU - Corona, A
AU  - Corona A
AD  - Bloomsbury Institute of Intensive Care Medicine, University College London, 
      London, UK. corona.alberto@libero.it
FAU - Cislaghi, F
AU  - Cislaghi F
FAU - Raimondi, F
AU  - Raimondi F
FAU - Singer, M
AU  - Singer M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - Italy
TA  - Minerva Anestesiol
JT  - Minerva anestesiologica
JID - 0375272
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
CIN - Minerva Anestesiol. 2008 May;74(5):153-4. PMID: 18414357
MH  - Anti-Bacterial Agents/*administration & dosage
MH  - Bacteremia/*drug therapy
MH  - Critical Illness
MH  - Humans
MH  - *Intensive Care Units
MH  - Italy
MH  - *Practice Patterns, Physicians'
MH  - Surveys and Questionnaires
MH  - United Kingdom
EDAT- 2008/04/17 09:00
MHDA- 2008/08/20 09:00
CRDT- 2008/04/17 09:00
PHST- 2008/04/17 09:00 [pubmed]
PHST- 2008/08/20 09:00 [medline]
PHST- 2008/04/17 09:00 [entrez]
PST - ppublish
SO  - Minerva Anestesiol. 2008 May;74(5):155-61; quiz 162-3.