The present study focuses on an interdisciplinary infectious disease subject.

We assessed the impact of infectious disease advice given in our university hospital, mainly risk factors for treatment failure after infectious disease advice.

We identified at-risk patient populations requiring particular attention from infectious disease specialists.

The present study revealed that the Charlson comorbidity score at admission (OR = 1.24, 95%CI [1.03–1.50]), a history of infection or colonization with multidrug-resistant bacteria (OR = 8.27, 95%CI [1.37–49.80]), compliance with suggested treatment modifications (OR = 0.09, 95%CI [0.01–0.67]), and deterioration of the patient's status on Day 3 after the infectious disease specialist's advice (OR = 12.50, 95%CI [3.16–49.46]) were associated with treatment failure after infectious disease advice in the multivariate analysis.

Risk factors associated with treatment failure after the infectious disease specialist's (IDS) advice remain unknown. We aimed to identify these risk factors.

We included patients hospitalized in our tertiary care center who consulted an infectious disease specialist between January 2013 and April 2015. Treatment failure was defined by a composite criterion: signs of sepsis beyond Day 3, ICU admission, or death. Treatment success was defined by the patient's sustained clinical improvement.

A total of 240 IDS recommendations were made. Diagnosis was changed for 64 patients (26.7%) and 50 patients experienced treatment failure after the IDS advice. In multivariate analysis, compliance with the IDS advice was associated with a higher rate of success (OR = 0.09, 95%CI [0.01–0.67]). Variables associated with treatment failure in the multivariate analysis were Charlson comorbidity score at admission (OR = 1.24, 95%CI [1.03–1.50]), a history of infection or colonization with multidrug-resistant bacteria (OR = 8.27, 95%CI [1.37–49.80]), and deterioration of the patient's status three days after the IDS advice (OR = 12.50, 95%CI [3.16–49.46]).

Reassessing IDS recommendations could be interesting for specific patients to further adapt and improve them.

Antimicrobial stewardship

Anti-infective agents

Multidrug-resistant bacteria

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