Nosocomial pneumonia: Search for an empiric and effective antibiotic regimen in high burden tertiary care centre
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- Gupta Nitin
- Department of Medicine, All India Institute of Medical Sciences
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- Soneja Manish
- Department of Medicine, All India Institute of Medical Sciences
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- Ray Yogiraj
- Department of Medicine, All India Institute of Medical Sciences
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- Sahu Monalisa
- Department of Medicine, All India Institute of Medical Sciences
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- Vinod Kutty Sharada
- Department of Medicine, All India Institute of Medical Sciences
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- Kapil Arti
- Department of Microbiology, All India Institute of Medical Sciences
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- Biswas Ashutosh
- Department of Medicine, All India Institute of Medical Sciences
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- Wig Naveet
- Department of Medicine, All India Institute of Medical Sciences
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- Sood Rita
- Department of Medicine, All India Institute of Medical Sciences
抄録
<p>The clinical practice guidelines on nosocomial pneumonia recommends an empirical regimen that would work in 95% of the patients based on the local antibiogram. The aim of the study was development of an antibiogram for guiding empiric therapy in settings with high prevalence of multi-drug resistant organisms. A retrospective review of electronic health records (e-hospital portal) was done to analyze all respiratory isolates from patients admitted in medical wards and intensive care unit between May 2016 and May 2017. The samples included brocho-alveolar lavage (BAL), mini broncho-alveolar lavage (mini-BAL) and endotracheal aspirate. The sensitivity pattern (combined and individual) of all bacterial isolates were analysed for commonly used antibiotics and their combinations. Out of the 269 isolates, the most common organisms were Pseudomonas aeruginosa (125, 46%), Acinetobacter baumanni (74, 27%) and Klebsiella pneumoniae (50, 19%). Cefoperazone-sulbactam (43%) had the best sensitivity pattern overall. Cefoperazone-sulbactam plus amikacin (56%) was the combination with the best combined sensitivity overall. There is a high prevalence of resistance in the commonly implicated organisms to the available antibiotics. There is an urgent need for implementation of effective anti-microbial stewardship programmes and development of newer antimicrobials.</p>
収録刊行物
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- Drug Discoveries & Therapeutics
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Drug Discoveries & Therapeutics 12 (2), 97-100, 2018-04-30
特定非営利活動法人 バイオ＆ソーシャル・サイエンス推進国際研究交流会