Longer than 2 hours to antibiotics is associated with doubling of mortality in a multinational community-acquired bacterial meningitis cohort



Eisen, Damon P, Hamilton, Elizabeth, Bodilsen, Jacob, Koster-Rasmussen, Rasmus, Stockdale, Alexander J ORCID: 0000-0002-5828-3328, Miner, James, Nielsen, Henrik, Dzupova, Olga, Sethi, Varun, Copson, Rachel K
et al (show 2 more authors) (2022) Longer than 2 hours to antibiotics is associated with doubling of mortality in a multinational community-acquired bacterial meningitis cohort. SCIENTIFIC REPORTS, 12 (1). 672-.

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Abstract

To optimally define the association between time to effective antibiotic therapy and clinical outcomes in adult community-acquired bacterial meningitis. A systematic review of the literature describing the association between time to antibiotics and death or neurological impairment due to adult community-acquired bacterial meningitis was performed. A retrospective cohort, multivariable and propensity-score based analyses were performed using individual patient clinical data from Australian, Danish and United Kingdom studies. Heterogeneity of published observational study designs precluded meta-analysis of aggregate data (I<sup>2</sup> = 90.1%, 95% CI 71.9-98.3%). Individual patient data on 659 subjects were made available for analysis. Multivariable analysis was performed on 180-362 propensity-score matched data. The risk of death (adjusted odds ratio, aOR) associated with treatment after two hours was 2.29 (95% CI 1.28-4.09) and increased substantially thereafter. Similarly, time to antibiotics of greater than three hours was associated with an increase in the occurrence of neurological impairment (aOR 1.79, 95% CI 1.03-3.14). Among patients with community-acquired bacterial meningitis, odds of mortality increase markedly when antibiotics are given later than two hours after presentation to the hospital.

Item Type: Article
Uncontrolled Keywords: Humans, Meningitis, Bacterial, Community-Acquired Infections, Nervous System Diseases, Anti-Bacterial Agents, Treatment Outcome, Retrospective Studies, Time Factors, Australia, Sweden, Female, Male, Propensity Score, Time-to-Treatment, Observational Studies as Topic, United Kingdom
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 13 Jan 2022 14:35
Last Modified: 18 Jan 2023 21:16
DOI: 10.1038/s41598-021-04349-7
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3146758