Association between early antibiotic treatment after admission and mortality of acute-on-chronic liver failure patients with bacterial infection: A multicenter retrospective study
Bacterial infection is a significant risk factor in the onset and development of acute-on-chronic liver failure (ACLF). Although early broad-spectrum antibiotic treatment is recommended, the optimal time to initiate antibiotic therapy remains unclear. This study aimed to investigate the relationship...
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Taylor & Francis Group
2025-12-01
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| Series: | Virulence |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/21505594.2025.2509757 |
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| author | Xinyi Chen Wenyi Chen Jiahang Zhou Jingyi Chen Guoqiang Cao Chenjie Huang Xiaoqing Lu Xiaoxiao Chen Rui Luo Haijun Huang Qiaoling Pan Jinfeng Yang Jiong Yu Hongcui Cao |
| author_facet | Xinyi Chen Wenyi Chen Jiahang Zhou Jingyi Chen Guoqiang Cao Chenjie Huang Xiaoqing Lu Xiaoxiao Chen Rui Luo Haijun Huang Qiaoling Pan Jinfeng Yang Jiong Yu Hongcui Cao |
| author_sort | Xinyi Chen |
| collection | DOAJ |
| description | Bacterial infection is a significant risk factor in the onset and development of acute-on-chronic liver failure (ACLF). Although early broad-spectrum antibiotic treatment is recommended, the optimal time to initiate antibiotic therapy remains unclear. This study aimed to investigate the relationship between the timing of antibiotic treatment and the prognosis of ACLF patients with bacterial infection. Patients with ACLF and bacterial infections upon admission were retrospectively evaluated. The predictors of 28-day mortality were identified using univariate, least absolute shrinkage and selection operator regression analysis, and multivariate logistic regression analyses. The “survminer” R package was used to categorize patients into two groups based on a 6-h threshold: early antibiotic administration (<6 h of admission) and later antibiotic administration (≥6 h after admission). A total of 295 patients were evaluated. The lungs were the most common site of infection (61.7% of patients had lung infections), followed by the peritoneum (25.4% of patients had spontaneous bacterial peritonitis). The time to first antibiotic administration was an independent predictor of 28-day mortality, and the odds of mortality increased by 2% for each hourly delay in antibiotic administration after admission. In Kaplan-Meier survival analysis, both 28-day and 90-day mortality rates were significantly lower in the early antibiotic group than in the later antibiotic group (both p < 0.0001). In conclusion, early antibiotic treatment is an independent predictor of 28-day mortality in ACLF patients with bacterial infections. Patients who received antibiotics less than 6 hours after admission exhibited lower 28- and 90-day mortality rates. |
| format | Article |
| id | doaj-art-2f5b7ede652044ea9fb0cc23d6593660 |
| institution | DOAJ |
| issn | 2150-5594 2150-5608 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Virulence |
| spelling | doaj-art-2f5b7ede652044ea9fb0cc23d65936602025-08-20T03:21:47ZengTaylor & Francis GroupVirulence2150-55942150-56082025-12-0116110.1080/21505594.2025.2509757Association between early antibiotic treatment after admission and mortality of acute-on-chronic liver failure patients with bacterial infection: A multicenter retrospective studyXinyi Chen0Wenyi Chen1Jiahang Zhou2Jingyi Chen3Guoqiang Cao4Chenjie Huang5Xiaoqing Lu6Xiaoxiao Chen7Rui Luo8Haijun Huang9Qiaoling Pan10Jinfeng Yang11Jiong Yu12Hongcui Cao13State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, ChinaState Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, ChinaState Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, ChinaState Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, ChinaState Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, ChinaState Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, ChinaState Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, ChinaState Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, ChinaState Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, ChinaDepartment of Infectious Diseases, Zhejiang Provincial People’s Hospital & People’s Hospital affiliated of Hangzhou Medical College, Hangzhou City, ChinaState Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, ChinaState Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, ChinaState Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, ChinaState Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, ChinaBacterial infection is a significant risk factor in the onset and development of acute-on-chronic liver failure (ACLF). Although early broad-spectrum antibiotic treatment is recommended, the optimal time to initiate antibiotic therapy remains unclear. This study aimed to investigate the relationship between the timing of antibiotic treatment and the prognosis of ACLF patients with bacterial infection. Patients with ACLF and bacterial infections upon admission were retrospectively evaluated. The predictors of 28-day mortality were identified using univariate, least absolute shrinkage and selection operator regression analysis, and multivariate logistic regression analyses. The “survminer” R package was used to categorize patients into two groups based on a 6-h threshold: early antibiotic administration (<6 h of admission) and later antibiotic administration (≥6 h after admission). A total of 295 patients were evaluated. The lungs were the most common site of infection (61.7% of patients had lung infections), followed by the peritoneum (25.4% of patients had spontaneous bacterial peritonitis). The time to first antibiotic administration was an independent predictor of 28-day mortality, and the odds of mortality increased by 2% for each hourly delay in antibiotic administration after admission. In Kaplan-Meier survival analysis, both 28-day and 90-day mortality rates were significantly lower in the early antibiotic group than in the later antibiotic group (both p < 0.0001). In conclusion, early antibiotic treatment is an independent predictor of 28-day mortality in ACLF patients with bacterial infections. Patients who received antibiotics less than 6 hours after admission exhibited lower 28- and 90-day mortality rates.https://www.tandfonline.com/doi/10.1080/21505594.2025.2509757Acute-on-chronic liver failurebacterial infectionearly antibiotics treatmentmortalityrisk factor |
| spellingShingle | Xinyi Chen Wenyi Chen Jiahang Zhou Jingyi Chen Guoqiang Cao Chenjie Huang Xiaoqing Lu Xiaoxiao Chen Rui Luo Haijun Huang Qiaoling Pan Jinfeng Yang Jiong Yu Hongcui Cao Association between early antibiotic treatment after admission and mortality of acute-on-chronic liver failure patients with bacterial infection: A multicenter retrospective study Virulence Acute-on-chronic liver failure bacterial infection early antibiotics treatment mortality risk factor |
| title | Association between early antibiotic treatment after admission and mortality of acute-on-chronic liver failure patients with bacterial infection: A multicenter retrospective study |
| title_full | Association between early antibiotic treatment after admission and mortality of acute-on-chronic liver failure patients with bacterial infection: A multicenter retrospective study |
| title_fullStr | Association between early antibiotic treatment after admission and mortality of acute-on-chronic liver failure patients with bacterial infection: A multicenter retrospective study |
| title_full_unstemmed | Association between early antibiotic treatment after admission and mortality of acute-on-chronic liver failure patients with bacterial infection: A multicenter retrospective study |
| title_short | Association between early antibiotic treatment after admission and mortality of acute-on-chronic liver failure patients with bacterial infection: A multicenter retrospective study |
| title_sort | association between early antibiotic treatment after admission and mortality of acute on chronic liver failure patients with bacterial infection a multicenter retrospective study |
| topic | Acute-on-chronic liver failure bacterial infection early antibiotics treatment mortality risk factor |
| url | https://www.tandfonline.com/doi/10.1080/21505594.2025.2509757 |
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