ANTIBIOTICS ADMINISTRATION TO ENHANCE THE SUCCESS OF THERAPY IN SEPSIS PATIENTS
DOI:
https://doi.org/10.22159/ajpcr.2017.v10s2.19496Keywords:
Sepsis, Antibiotics, De-escalation of antibiotics, CultureAbstract
Objective: Sepsis is reported to cause 9.3% death from the total 250,000 patients in the United States. De-escalation of antibiotics is expected to increase the effectiveness of therapy, to decrease in the level of antibiotic resistance and to reduce mortality in sepsis patients. The purpose of this study was to describe the frequency and characteristics of de-escalation of antibiotics in patients with sepsis and its influence on patient.
Method: The study was conducted retrospectively with purposive sampling in hospitalized patients in a hospital in Yogyakarta, to the patients whose age are above 15 years, in the month of January to December 2015. Totally 162 patients were included, in demographic, antibiotic regimens, duration of antibiotic treatment, de-escalation of antibiotics treatment, the culture results, mortality, and length of hospital stay (LoS).
Result: The result showed that 116 patients were without de-escalation of antibiotics where the majority of cases is the absence of changes in the types of antibiotics that are given from the start of the therapy until the treatment is completed. The age of the most sepsis patients treated is about 46-60 years (36.4%), LOS was 6-10 days highest (27.2%), the number of patient received antibiotics for hospitalized majority 1-2 types of antibiotics (46.9%), originally most of the patients' room are as many as those from emergency unit 63.6%, clinical outcomes patients who were recovered as many as 46.3%, the most co-morbidities that frequently appear in sepsis patients is pneumonia is 616.6% cases. Patients who were examined culture is 29%.
Conclusion: Giving antibiotics is appropriate and adequate to prevent the possibility of resistance and death and the de-escalation strategy is a strategy that is safely used to treat patients with sepsis.
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References
Kakkilaya, Srinivas. Rational Medicine: Rational use of antibiotics [internet]. Available from http://www.rational medicine.org/antibiotics.htm.[cited 2011 September 25]
Garnacho-Montero J, Garcia-Garmendia JL, Barrero-Almodovar A, Jimenez-Jimenez FJ, Perez-Paredes C, Ortiz-Leyba C. Impact of adequate empiric antibiotic therapy on the outcome of patients admitted to the intensive care unit with sepsis. Critical Care Medicine2003;31 Suppl 12:2742–51. [PUBMED: 14668610.
American Thoracic Society, Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare- associated pneumonia. Am J RespirCrit Care Med. 2005.17:388-416.
Rea-Neto A. Youssef NCM. Tuche F. Brunkhorst F. RanieriVM.Reinhart K.et. al. Diagnosis of ventilator-associated pneumonia.a systematic review of literature. Crit Care Med. 200. 12:1186-97.
NiedermanMS.Craven DE. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. AmJRespirCrit Care Med.200.171:388-416.
ChastreJ.Fagon J. Ventilator-associated pneumonia: state of the art. Am J RespirCrit CareMed. 2002. 165:867-93.
TejerinaE.Frutos-VivarF.RestrepoMIAnzuetoA.AbrougF.Palizas F.et al. Incidence, risk factors, and outcome of ventilator-associated pneumonia. J Crit Care. 2006:21:56-65.
Lagamayo EN. Antimicrobial resistance in major pathogens of hospital-acquired pneumonia in Asian Countries. Am J Infect Control. 2008. 36:101-8.
Niederman MS. The Importance of de-escalating antimicrobial therapy in patients with ventilator-associated pneumonia. Respir and Crit Care Med. 2006.27:45-5.
Kollef MH. Optimizing antibiotic therapy in the Intensive Care Unit setting. Crit Care Med.2001.5:189-95.
Alvarez-Lerma F. Empiric broad-spectrum antibiotic therapy of nosocomial pneumonia in the intensive care unit: a prospective observational study. Crit Care Med. 2006.14:1-11.
Niederman MS. The Importance of de-escalating antimicrobial therapy in patients with ventilator-associated pneumonia. RespirCrit Care Med. 2006.27:45-20
Kollef MH. The importance of antimicrobial resistance in hospital-acquires and ventilator associated pneumonia.CurrAnaestAndCritCare. 2005. 16:209-19.
Paul M.Benuri-Silbiger I. Soares-Weiser K.Liebovici L. β-Lactam monotherapy versus β- lactam–aminoglycoside combinationtherapy for sepsis in immunocompetent patients: systematic review and metaanalysis of randomised trials.BMJ.2004. 18:301-11.
American Thoracic Society. Guidelines for the management of adults with community acquired pneumonia. Diagnosis, assessment of severity, antimicrobial therapy and prevention. Am J RespirCrit Care. 2001. 163 : 1730-54.
Nicolau DP. Pharmacodynamic optimization of β-lactams in the patient care setting. CritCare Med. 2008. 12:1-5
Rello J, Vidaur L, Sandiumenge A, Rodrı´guez A, Gualis B, Boque C, Diaz E (2004) De- escalation therapy in ventilator associated pneumonia. Crit Care Med 32:2183–2190
Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR, Epidemiology ofe severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med 2001; 29: 1303-1310.
Song JH. Treatment recommendations of hospital-acquired pneumonia in Asian countries:first consensus report by the Asian HAP working group. Am J Infect Control. 2008. 36:83-92
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