Empirical antipseudomonal antibiotic therapy and in-hospital mortality in biliary tract infections with bacteremia: a multicenter retrospective cohort study in Japan.

Authors

Koji Endo, Hiroyoshi Iwata, Makoto Kaneko, Keisuke Kamada, Yuki Honda, Yoshito Homma, Takao Wakabayashi, Kenji Kanto, Yuki Nagai, Shuhei Hamada, Takashi Saito, Kyoji Hashimoto, Takuya Aoki

Published in

Infection. Aug 21, 2026. Epub Aug 21, 2026.

Abstract

To evaluate the association between the use of empirical antipseudomonal antibiotics and in-hospital mortality in patients with bacteremia due to biliary tract infections.
We conducted a multicenter retrospective cohort study using data from the JApan Bacteremia Inpatient Cohort Association (JA-BICA), a database of 1105 adult inpatients with bacteremia sourced from eight community general hospitals across Japan. Adult patients with bacteremia due to biliary tract infections were included in this study. Patients who received empirical antipseudomonal antibiotics on the day of hospital admission were categorized into the exposure group and those who did not receive such antibiotics were categorized into the comparison group. The primary outcome measure was the all-cause in-hospital mortality. We evaluated the association between antipseudomonal antibiotic use and in-hospital mortality using cumulative incidence functions and the Fine-Gray subdistribution hazard models with propensity score-based stabilized inverse probability of treatment weighting (IPTW). The missing covariates were addressed using multiple imputations.
Among 216 eligible patients, 160 (74.0%) received empirical antipseudomonal antibiotics. IPTW-weighted Fine-Gray analysis showed no detectable association between antipseudomonal antibiotic use and in-hospital mortality (subdistribution hazard ratio, 1.02; 95% CI, 0.4-2.59; P = 0.96).
In the present study, no clear association was observed between empirical antipseudomonal antibiotic therapy and in-hospital mortality in patients with bacteremia due to biliary tract infection; however, the estimate was imprecise due to the limited number of events. These findings highlight the need for further studies to guide empirical antibiotics selection in this population.

PMID:
42627621
Bibliographic data and abstract were imported from PubMed on 22 Aug 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.