Bacteremia in patients discharged from the emergency unit

BACKGROUND: To know the clinical and epidemiologic characteristics, the evolution and the rate of adequate empiric antibiotic treatment in adult patients with a bacteremia discovered after discharge from an emergency unit. PATIENTS AND METHOD: During 10 years (1989-1998), we registered the clinical and epidemiological data from patients with a bacteremia detected after discharge from emergency. The results were compared with those of patients admitted to hospital who had a community-acquired bacteremia. RESULTS: 85 patients were analysed (52 males), 45% aged over 70 years. overall, they represented 13.9% of community-acquired bacteremias detected during the same period. Most frequent source was the urinary tract (69%) followed by an unknown source (12%). E. coli was isolated in 62% of cases. In 16 cases, treatment was considered incorrect. Three patients died. CONCLUSIONS: A non-worthless number of patients with bacteremia are discharged from the emergency unit, and 21% of them receive inadequate treatment. Fatal outcome is rare but avoidable in some cases.