Ofcial Journal of the Brazilian Association of Infection Control and Hospital Epidemiology Professionals J Infect Control 2013; 2 (3):146-149 Page 01 of 03 not for quotation Te primary bloodstream infections (BSI) are important causes of morbidity and mortality in developing countries, due to severity of the disease and inadequate empirical therapeutical regimens. Te main objective of this pilot study was to retrospecti- vely assess appropriateness of prescribing antibiotics for treating laboratory-confrmed BSI in two intensive care units (ICU) located in a large university hospital, according to susceptibility profle of the isolated agents. During the study period (January 1st, 2011 to August 31st, 2012) a total of 47 patients had laboratory-confrmed BSI, and 57 pathogens were isolated in blood cultures. Twenty-two patients (47%) were female and 25 male (53%), mean age of 58 years (range 23-84). Regarding types of patients, 19 (40%) sufered from clinical conditions and 28 (60%) underwent surgical procedures. Te mean time to initiate empirical treatment was 38 hours, with no statis- tically signifcant diference in patient type. Empirical treatment was considered adequate in 58% of cases, inappropriate in 23%, and was not started before culture results in 19%, with no statistically signifcant diference between patient types. Of the 57 pathogens isolated from blood cultures, 42 (74%) were Gram-negative and 15 (26%) Gram-positive, and the most prevalent agent was Acineto- bacter baumannii (n=18; 31.6%), followed by Klebsiella pneumoniae (n=5; 8.8%), Pseudomonas aeruginosa (n=5; 8.8%), Serratia marcescens (n=5; 8.8%) and coagulase-negative staphylococci (n=5; 8.8%). Staphylococcus aureus was isolated in only 7% of the samples. As for multidrug resistance, the overall percentage was 53% (30/57), and Acinetobacter baumannii (78% - 14/18), Pseudomonas aeruginosa (60% - 3/5) and S. aureus (100%, 4/4) presented the lowest sensitivity profle. Tus, a larger prospective study is suggested to confrm these preliminary data. Te fnal results may be used to guide the revision of treatment protocols and intensifcation of preventive measures. Keywords: Bloodstream infection, empirical therapy, mul- tidrug resistance, sensitivity profle, therapy appropriateness. ABSTRACT Empirical therapy of bloodstream infection in university hospital Cíntia Faiçal Parenti, 1 Paulo Henrique Orlandi Mourão, 1 José Carlos Matos, 1 Roberta Maia de Castro Romanelli, 1 Wanessa Trindade Clemente 1 1 Universidade Federal de Minas Gerais / Hospital clínicas, Minas Gerais, MG, Brazil. Recebido em: 29/10/13 Aceito em: 04/04/14 parenti@gold.com.br ORIGINAL ARTICLE INTRODUCTION Primary bloodstream infections (BSI) are important causes of morbidity and mortality in developing countries, due to severity of the disease and an increased number of agents resistant to the commonly prescribed antimicrobials (MA- CHARASHVILI et al., 2009). Among the infections caused by Gram-positive organisms, the high percentage of methicillin- -resistant Staphylococcus aureus (MRSA) and the emergence of glycopeptide-resistant strains are a concern (SIEVERT et al., 2002). Among the Gram-negative agents, increasing rates of car- bapenem resistance and the emergence of polymyxin-B-resistant strains challenge physicians in the difcult task of treating pa- tients with such infections (CLÍMACO, 2011). Early and appropriate treatment of the BSI is essential to reduce mortality of patients, and it is recommended to start em- pirical treatment as soon as possible, employing antimicrobial regimen for the most prevalent agents in the organization and considering their sensitivity (KALLEL et al., 2010). On the other hand, the indiscriminate use of antibiotics, no compliance to cli- nical protocols and neglecting the need to adjust treatment afer antibiogram results can induce the emergence of multidrug- -resistant strains (JACOBY, 2008). Te main objective of this pilot study was to examine the appropriateness of prescriptions for laboratory-confrmed BSI in intensive care units (ICU) of a large university hospital, accor- ding to microbial sensitivity. MATERIAL AND METHODS Tis is a retrospective study including all patients in two ICU that presented laboratory-confrmed BSI (according to the