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ORIGINAL ARTICLE
Year : 2017  |  Volume : 3  |  Issue : 1  |  Page : 29-35

Correlation of empiric antibiotic use with susceptibility pattern of blood isolates in septicemic patients in an Intensive Care Unit


1 3rd Year MBBS Student, Pondicherry Institute of Medical Sciences, Puducherry, India
2 Department of Microbiology, Pondicherry Institute of Medical Sciences, Puducherry, India

Correspondence Address:
K Sandhya Bhat
Department of Microbiology, Pondicherry Institute of Medical Sciences, Puducherry
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcrsm.jcrsm_15_17

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Background: Bloodstream infections remain a major cause of mortality and morbidity. Respiratory tract, genitourinary tract, and intra-abdominal foci are often the common identifiable foci of these infections. Definitive treatment based on blood cultures and susceptibility is essential to treat sepsis cases for better outcome. This study was conducted to document the bacteriological profile, their susceptibility pattern, antibiotics used for empiric and definitive treatment, escalation or de-escalation of antibiotics done following antibiogram report. Materials and Methods: descriptive study was carried out for a period of 1 year after obtaining waiver of consent from Institute Ethics Committee. Demographic details, length of hospital stay, risk factors, bacteriological profile with antimicrobial resistance pattern, empiric antibiotic and definitive antibiotic given and outcome of patient were recorded. Statistical analysis was done by using IBM SPSS version 16.0 (SPSS Inc., Chicago, IL, USA) software. Results: Overall prevalence of sepsis was 9.5%. Gram-negative bacteria were more commonly isolated (62.8%) than Gram-positive bacteria (37.2%), and Escherichia coli was the most common isolate (24.3%). Antimicrobial resistance among Gram-negative bacterial isolates was maximum with ciprofloxacin (51.3%) and ceftriaxone (45.2%), and least with amikacin, imipenem (16.7%), and polymyxin B (2.6%). Penicillin group of antibiotics were commonly used for empiric treatment, and glycopeptides/polymyxins and carbapenems were most preferred for definitive treatment. Conclusion: Knowledge about prevalence, risk factors, bacteriological profile, and their antibiogram resistance pattern is essential to select the antibiotic for the empiric treatment of suspected cases of sepsis and to formulate antibiotic policy. It is also important to de-escalate/escalate antibiotics according to the susceptibility report for a better outcome and to shorten the period of morbidity.


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