Antimicrobial outcome evaluation

Toxicity Monitor and assess for adverse effects and evaluate antimicrobial serum concentrations when appropriate to minimize toxicity and improve outcomes... 

Many studies have been conducted evaluating or comparing the effectiveness of antimicrobials for treatment of intraabdominal infections. Substantial differences in patient outcomes from treatment with a variety of agents generally have not been demonstrated. 

If symptoms do not improve, the patient should be evaluated for persistent infection. There are many reasons for poor patient outcome with intraabdominal infection improper antimicrobial selection is only one. The patient maybe immunocompromised, which decreases the likelihood of successful outcome with any regimen. It is impossible for antimicrobials to compensate for a nonfunctioning immune system. There may be surgical reasons for poor patient outcome. Failure to identify all intraabdominal foci of infection or leaks from a GI anastomosis may cause continued intraabdominal infection. Even when intraabdominal infection is controlled, accompanying organ system failure, most often renal or respiratory, may lead to patient demise. 

Orhan I, Ozcelik B, ener B (2007) Current Outcomes of Antiviral and Antimicrobial Evaluation of Some Heterocyclic Compounds from Turkish Plants. 11 303-323 Ozcelik B, see Orhan I (2007) 11 303-323... 

To evaluate impact of antimicrobial intervention program OD None None Clinical and microbiologic indicators, laboratory costs, DCA Savings 38,920 over 7 mo projected annual savings 107,000 Input costs not considered assumed quality and clinical outcome to be equal... 

Finally, there are times when an exploratory, observational study is necessary. For example, in evaluating the antimicrobial properties of different kinds of skin preparation for long-term venous catheterization, observational studies will be required, in which outcomes for patients are observed in situ, instead of in a controlled study. 

Based on safety concerns with cefepime compared to other antimicrobials, a retrospechve study was conducted to evaluate the clinical outcomes of 532 paediatric patients with cancer who received either ceftazidime or cefepime for suspecfed or proved infections. No statistically significant difference was seen in patienfs who received cefepime compared to those who received ceftazidime. While these data are encouraging, it should be interpreted cautiously due to the retrospective design and limited power of the study, though it does agree with the most recent FDA reporting of a meffl-analysis that reported no mortality disadvantage to cefepime use for its approved indications [61 , 62 ]. 

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