Impact of Empirical Antibiotics Therapy on the Clinical Outcomes of Adult Patients Admitted to the Intensive Care Units with Sepsis in Sudan Impact of emperical antibiotics on the clincal outcomes of adult patients admitted to the intensive care unit with sepsis

Main Article Content

Tasabeeh Hamad Galal Abdalla Bushra Salman Bashir A. Yousef


Introduction: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to an infection. Early recognition and administration of appropriate empirical antibiotic therapy are associated with lower mortality rate and shorter length of stay. This study aims to identify the risk factors for developing sepsis, the common sites of infection, the isolated microorganisms, and to evaluate the impact of appropriate empiric antibiotic on the mortality rate and length of stay the in two tertiary care hospitals in Sudan.

Methodology: A prospective hospital-based study was done on 30 patients who were admitted to the intensive care unit (ICU) during a four-month study period. Data were retrieved from patients’ records. Data were analyzed using SPSS Version 20.

Results: Out of the 30 study patients, 43% were females. The median age of the group was 68 years and 57% of the patients were above 65 years. The most common risk factor for developing sepsis was diabetes mellitus (23.33%), followed by malignancy (16.67%). The most common site of infection was the chest (33.33%). In total, 19 different regimens of empirical antibiotics were prescribed, where 43.4% were appropriate and 56.6% were inappropriate. Among the studied population, 18 patients died and the overall mortality was 60%. The study found that in patients who received appropriate empiric antibiotics, mortality significantly decreased (p = 0.006). Patients who received appropriate treatment were also found to have a numerically 4-days shorter length of ICU stay but this did not reach statistical significance due to small sample size.

Conclusions: The study concluded that diabetes mellitus is the most common risk factor for developing sepsis, followed by malignancy. Gram-negative organisms are the most common isolated microorganisms. Respiratory infection is the most common source of infections. The prescribed empirical antibiotics were mostly inappropriate. Moreover, patients with appropriate empirical antibiotics had shorter ICU stays and increased survival when compared with those who had inappropriate treatment.

Keywords: Sepsis, ICU, Antibiotics

Article Details

How to Cite
HAMAD, Tasabeeh et al. Impact of Empirical Antibiotics Therapy on the Clinical Outcomes of Adult Patients Admitted to the Intensive Care Units with Sepsis in Sudan. Medical Research Archives, [S.l.], v. 12, n. 4, apr. 2024. ISSN 2375-1924. Available at: <>. Date accessed: 27 may 2024. doi:
Research Articles


1. Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-810. doi: 10.1001/jama.2016.0287

2. Fleischmann C, Scherag A, Adhikari NKJ, et al. Assessment of global incidence and mortality of hospital-treated sepsis. Current estimates and limitations. Am J Respir Crit Care Med. 2016;193(3):259-272. doi:10.1164/ rccm.201504-0781OC

3. Fraser A, Paul M, Almanasreh N, et al. Benefit of appropriate empirical antibiotic treatment: thirty-day mortality and duration of hospital stay. Am J Med. 2006;119(11):970-976. doi:10.1016/j.amjmed.2006.03.034

4. McPherson D, Griffiths C, Williams M, et al. Sepsis-associated mortality in England: an analysis of multiple cause of death data from 2001 to 2010. BMJ Open. 2013;3(8):e002586. doi:10.1136/bmjopen-2013-002586

5. Martin GS, Mannino DM, Moss M. The effect of age on the development and outcome of adult sepsis. Crit Care Med. 2006;34(1):15-21. doi:10.1097/

6. Pfaller MA, Messer SA, Hollis RJ, et al. Variation in susceptibility of bloodstream isolates of Candida glabrata to fluconazole according to patient age and geographic location in the United States in 2001 to 2007. J Clin Microbiol. 2009;47(10):3185-3190. doi:10.1128/JCM.00946-09

7. Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of clinical criteria for sepsis: for the Third International Consensus Definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):762-774. doi:10.1001/jama.2016.0288

8. Levy MM, Fink MP, Marshall JC, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med. 2003;31(4):1250-1256. doi:10.1097/01.CCM.0000050454.01978.3B

9. Rhodes A, Evans LE, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med. 2017 ;43(3):304-377. doi:10.1007/s00134-017-4683-6

10. MacArthur RD, Miller M, Albertson T, et al. Adequacy of Early Empiric Antibiotic Treatment and Survival in Severe Sepsis: Experience from the MONARCS Trial. CLIN INFECT DIS. 2004;38(2):284-288. doi:10.1086 /379825

11. Garnacho-Montero J, Garcia-Garmendia JL, Barrero-Almodovar A, Jimenez-Jimenez FJ, Perez-Paredes C, Ortiz-Leyba C. Impact of adequate empirical antibiotic therapy on the outcome of patients admitted to the intensive care unit with sepsis*. Critical Care Medicine. 2003;31(12):2742. doi:10.1097/01.CCM.0000098031.24329.10

12. Guo Y, Gao W, Yang H, Ma C, Sui S. De-escalation of empiric antibiotics in patients with severe sepsis or septic shock: A meta-analysis. Heart Lung. 2016;45(5):454-459. doi:10.1016/j.hrtlng.2016.06.001

13. Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med. 2003;348(16):1546-1554. doi:10.1056/ NEJMoa022139

14. Gilbert DN, Chambers HF, Saag MS, et al. The Sanford Guide to Antimicrobial Therapy 2021. 51st ed. Antimicrobial Therapy, Incorporated; 2021.

15. Levy MM, Rhodes A, Phillips GS, et al. Surviving Sepsis Campaign: association between performance metrics and outcomes in a 7.5-year study. Crit Care Med. 2015;43(1): 3-12. doi:10.1097/CCM.0000000000000723

16. Ibarz M, Haas LEM, Ceccato A, Artigas A. The critically ill older patient with sepsis: a narrative review. Ann Intensive Care. 2024;14:6. doi:10.1186/s13613-023-01233-7

17. Failla KR, Connelly CD. Systematic Review of Gender Differences in Sepsis Management and Outcomes. J Nurs Scholarsh. 2017;49(3):312-324. doi:10.1111/j nu.12295

18. Bongomin F, Kibone W, Okot J, Nsenga L, Olum R, Baluku JB. Fungal diseases in Africa: epidemiologic, diagnostic and therapeutic advances. Ther Adv Infect Dis. 2022;9:20499361221081441. doi:10.1177/20499361221081441

19. Lakbar I, Medam S, Ronflé R, et al. Association between mortality and highly antimicrobial-resistant bacteria in intensive care unit-acquired pneumonia. Sci Rep. 2021; 11(1):16497. doi:10.1038/s41598-021-95852-4

20. Baumgardner DJ. Soil-related bacterial and fungal infections. J Am Board Fam Med. 2012;25(5):734-744. doi:10.3122/jabfm.2012.05.110226

21. Danai PA, Moss M, Mannino DM, Martin GS. The epidemiology of sepsis in patients with malignancy. Chest. 2006;129(6):1432-1440. doi:10.1378/chest.129.6.1432

22. Kollef MH, Sherman G, Ward S, Fraser VJ. Inadequate antimicrobial treatment of infections: a risk factor for hospital mortality among critically ill patients. Chest. 1999;115(2 ):462-474. doi:10.1378/chest.115.2.462

23. Khan RA, Bakry MM, Islahudin F. Appropriate Antibiotic Administration in Critically Ill Patients with Pneumonia. Indian J Pharm Sci. 2015;77(3):299-305. doi:10.4103/ 0250-474x.159623