BACKGROUND: @entity796 is a common cause of @entity2489 ( @entity2489 ). Guidelines recommend dual coverage of @entity796 , but the beneficial effect of combination therapy is controversial. We described antibiotic prescriptions and evaluated the clinical impact of initial combination antibiotic therapy and de-escalation strategy in @entity1 with @entity2489 caused by @entity796 . METHODS: Between 1994 and 2014, all 100 @entity1 with @entity2489 caused by @entity796 in our intensive care unit (ICU) were included in a retrospective cohort study to evaluate the prognostic impact of initial combination antibiotic therapy. RESULTS: Eighty-five @entity1 received initial combination antibiotic therapy and 15 monotherapy. Nine @entity1 received inadequate initial antibiotic therapy. De-escalation was performed in 42 @entity1 . Thirty-nine @entity1 died in the ICU. Factors independently associated with @entity204 were SAPS II score [SAPS II >= 40 versus   <40: hazard ratio (HR) 2.49, 95% confidence interval (CI) 1.08-5.70, p   =   0.03] and @entity326 (HR   =   4.80, 95% CI   =   1.90-12.16, p   <   0.01) at onset of @entity2489 . Initial combination antibiotic therapy (HR   =   1.97, 95% CI   =   0.56-6.93, p   =   0.29) and early de-escalation (HR   =   0.59, 95% CI   =   0.27-1.31, p   =   0.19) had no impact on mortality. In multivariate analysis, the risk for inappropriate initial antibiotic therapy was higher in cases with multi-drug resistant @entity796 [odd ratio (OR)   =   7.11, 95% CI   =   1.42-35.51, p   =   0.02], but lower in cases with initial combination antibiotic therapy (OR   =   0.12, 95% CI   =   0.02-0.63, p   =   0.01). CONCLUSION: In our cohort, combination therapy increased the likelihood of appropriate therapy but did not seem to impact on mortality.

Impact of combination therapy and early de-escalation on outcome of @entity2489 caused by XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity796 :: ('287', 'Species') :: ['Pseudomonas aeruginosa', 'P. aeruginosa'] @entity326 :: ('MESH:D012772', 'Disease') :: ['septic shock'] @entity2489 :: ('MESH:D053717', 'Disease') :: ['ventilator-associated pneumonia', 'VAP'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity796 :: (287,Species) :: ['Pseudomonas aeruginosa']
