Optimal Antibiotic Treatment of Moderate to Severe Bacterial Infections

Inclusion Criteria

• •The rationale of the study will be to address patients for whom antibiotic treatment is, or should be, considered. Thus we will include consecutive patients detected in medical departments according to the following criteria:
• •1. Patients from whom blood cultures were drawn or
• •2. All patients for whom antibiotic treatment (but not prophylaxis or intra-peritoneal, inhalation or local antibiotics therapy ) is started within the last 96 days or
• •3. Patients fulfilling the CDC diagnostic criteria for any infection (see appendix C) or
• •4. Patients with temperature ≥38.3 measured orally (or 38 axillary or 38.5 rectal) on a single measurement or ≥38 / \< 36 on at least 2 consecutive measurements separated at least 1 hr apart and one of the next criteria:
• •(a) heart rate \>90 beats/minute; (b) respiratory rate \>20 breaths/minute or partial pressure of CO2 \<32 mm Hg; and (c) white blood cell count \>12,000/ L, \<4000 L, or \>10% immature (band) forms. or
• •5. Patients with shock compatible with septic shock. As defined as hypotension (arterial blood pressure \<90 mmHg systolic, or 40 mmHg less than patient's normal blood pressure) for at least 1 h despite adequate fluid resuscitation; Or Need for vasopressors to maintain systolic blood pressure \>90 mmHg or mean arterial pressure \>70 mmHg and a suspected source of infection.