Clinical features, microbiology, and vancomycin regimens in sepsis patients: A retrospective study conducted at a single infectious diseases center

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Despite increasing antibiotic resistance, vancomycin remains the first choice to treat severe infections due to drug-resistant gram-positive bacteria. This study aimed to summarise the clinical, microbiological, and vancomycin treatment outcomes in bacteremia patients. From July to December 2019, a retrospective cohort analysis was conducted on patients with bacteremia treated with vancomycin at a tertiary hospital in Hanoi, Vietnam. Patients without vancomycin concentrations were excluded from the study. Patients had a median age of 54 years (IQR, 41.8 - 63.3), with a male/female ratio of 1.86. Renal complication was markedly different; Clcr < 60, 60 - 130, and > 130 mL/min was 29%, 60%, and 11%, respectively. The median Charlson score was 3.0 (2-4.3), the qSOFA score was 1 (1-2), and the NEWS score was 76%, with a median of 6 (5-8). Twenty-one cases had positive blood culture where85.7% were gram-positive. 93% of patients with sepsis were treated with vancomycin as the first antimicrobial, of which 72% used vancomycin in combination with other antibiotics. Renal complications occurred in 12% of all patients, with grades R, I, and F accounting for 4%, 5%, and 3%, respectively. The median duration of treatment was 12 days (IQR, 7-17), with a success rate of 82 % and a failure rate of 18%, respectively. Conclusions: In most patients with bacteremia, microbiological tests reveal no detectable bacteria. When sepsis is suspected, a vancomycin regimen should be initiated.