Résumé
Background: aminoglycosides are recommended for treatment of septic shock in intensive care unit (ICU) patients, but it’s still debated. The aim of this study is to evaluate the impact of empiric aminoglycoside adjunction in broadening antimicrobial spectrum. The management of septic shock in the ICU represents a major challenge for clinicians, and prompt initiation of antibiotic therapy is a critical intervention as early and effective antimicrobial therapy is associated with improved outcomes in patients with severe infections. To increase the probability of appropriate antimicrobial therapy, combination therapy, defined as the concomitant use of two or more antibiotics of different classes with different spectrum of activity, has been used in critically ill patients or those infected with multidrug resistant (MDR) pathogens.Methods: we distinguished the three following categories of empirical antimicrobial therapy based on the antimicrobial susceptibility pattern of the causative pathogen(s): first group of patients whom all pathogens identified were susceptible to BL, whatever their susceptibility to AG, a second group when at least one pathogen identified was resistant to BL, and susceptible to AG and a third group in which at least one pathogen identified was resistant to both BL and AG.Results: the proportion of patients for whom the addition of AG improved bacterial coverage represented 23.4% (46/197) of the study cohort.Conclusion: in 23.4% (46/197) of our cohort’s patients, an empirical combination therapy including an AG permitted to broaden the antimicrobial spectrum and thereby to have an appropriate empirical antimicrobial therapy. These results support the current guidelines and common practices and impel to do further randomized controlled trials.