Antibiotic prescription, organisms and its resistance pattern in patients admitted to respiratory ICU with respiratory infection in Mysuru

JOURNAL TITLE: Indian Journal of Critical Care Medicine

Author
1. M Mahendra
2. KS Lokesh
3. Sneha Limaye
4. BS Jayaraj
5. Vivek Veerapaneni
6. Raja Dhar
7. SK Chaya
8. Shrikant Ambalkar
9. Rajesh Swarnakar
10. PA Mahesh
ISSN
0972-5229
DOI
10.4103/ijccm.IJCCM_409_17
Volume
22
Issue
4
Publishing Year
2018
Pages
8
Author Affiliations
    1. Apollo Gleneagles Hospital, 58, Cannel circular road, Kolkata, West Bengal, India
    2. Apollo Gleneagles Hospital 58, Cannel Circular Road Kolkata, West Bengal, India
    3. Jadavpur University, Kolkata, West Bengal, India
    4. Fortis Hospital, Kolkata, West Bengal, India
    5. Fortis Hospital, Anandapur, Kolkata, West Bengal, India
    6. Fortis Hospital, Kolkata, West Bengal, India; National Allergy Asthma Bronchitis Institute
    7. Fortis Hospitals, Kolkata, West Bengal, India
    1. Chest Research Foundation, Pune, Maharashtra, India
    2. Marigold Complex, Kalyaninagar, Pune, Maharashtra, India
    1. Pulmonary Medicine, Shimoga Institute of Medical Sciences, Shivamogga Mysore, Karnataka, India
    1. Pulmonary Medicine, JSS Medical College, JSS University, Mysore, Karnataka, India
    1. Pulmonary Medicine, JSS Medical College, JSS University, Mysore, Karnataka, India
    1. Pulmonary Medicine, JSS Medical College, JSS University, Mysore, Karnataka, India
    1. Pulmonary Medicine, JSS Medical College, JSS University, Mysore, Karnataka, India
    1. Pulmonary Medicine, Getwell Hospital and Research Institute, Dhantoli, Nagpur, Maharashtra, India
    1. Department of Clinical Microbiology & Infection, King\'s Mill Hospital, Sherwood Forest Hospitals NHS Trust, Sutton in Ashfield, Nottinghamshire NG17 4JL, UK
    1. Pulmonary Medicine, JSS Medical College, JSS University, Mysore, Karnataka, India
  • Article keywords
    Antibiotic resistance, mortality, pneumonia, respiratory infection

    Abstract

    Aim of Study: Respiratory infections account for significant morbidity, mortality and expenses to patients getting admitted to ICU. Antibiotic resistance is a major worldwide concern in ICU, including India. It is important to know the antibiotic prescribing pattern in ICU, organisms and its resistance pattern as there is sparse data on Indian ICUs. Materials and Methods: We conducted a prospective study from August 2015 to February 2016. All patients getting admitted to RICU with respiratory infection who were treated with antibiotics were included into study. Demographic details, comorbidities, Clinco-pathological score (CPI) on day1 and 2 of admission, duration of ICU admission, number of antibiotics used, antibiotic prescription, antimicrobial resistance pattern of patients were collected using APRISE questionnaire. Results: During study period 352 patients were screened and 303 patients were included into study. Mean age was 56.05±16.37 and 190 (62.70%) were men. Most common diagnosis was Pneumonia (66%). Piperacillin-tazobactam was most common empirical antibiotic used. We found 60% resistance to piperacillin-tazobactam. Acinetobacter baumanii was the most common organism isolated (29.2%) and was highly resistant to Carbapenem (60%). Klebsiella pneumoniae was resistant to Amikacin (45%), piperacillin (55%) and Ceftazidime (50%). Conclusion: Piperacillin-tazobactam was the most common antibiotic prescribed to patients with respiratory infection admitted to ICU. More than half of patients (60%) had resistance to the empirical antibiotic used in our ICU, highlighting the need for antibiogram for each ICU. Thirty six percent of patient had prior antibiotic use and had mainly gram negative organisms with high resistance to commonly used antibiotics.

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