DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20160462

A questionnaire based survey to evaluate the usage pattern of carbapenems for sepsis management in intensive care unit

Vikram Kumar Shetty, Vishwaprakash M. K., Somashekara S. C.

Abstract


Background: Sepsis remains one of the most common critical illnesses for patients to be admitted to an intensive care unit (ICU) and has very high associated morbidity and mortality ranging from 18 to 50%. It is a well-known fact that early goal directed therapy with broad spectrum antibiotics, IV fluids and other supportive therapies improve outcome. The current study was done to know the importance of carbapenems in the management of sepsis focusing on perceived use and the clinical outcome in real time setting in tertiary care hospitals.

Methods: A structured questionnaire designed to collect information on the perceived use of carbapenems, the clinical outcome, response period for clinical cure and combination antibiotic therapy preferred with carbapenem was circulated among 50 clinicians in tertiary care hospitals and nursing homes in and around Mangalore between January 2015 to March 2015.

Results: Majority of doctors (>80%) felt that carbapenems a broad spectrum antibiotic administration provided good clinical improvement in hospital infections along with improvement in blood cell count and bacteriological cure.

Conclusions: Our study provides an important insight regarding the knowledge, practice pattern and clinical outcome through the use of carbapenem in Sepsis management in ICU’s around Mangalore. The experience of practice patterns and clinical outcomes with carbapenem shared by doctors through this survey is similar to that in other studies.


Keywords


Carbapenems, Sepsis, Early goal directed therapy, Antibiotic policy, Bacteriological cure

Full Text:

PDF

References


Levinson AT, Casserly BP, Levy MM. Reducing mortality in severe sepsis and septic shock. Available at http://www.medscape.com/ viewarticle/ 749208. Accessed on 23 December 2015 at 12pm.

Divatia JV. Reducing the burden of severe sepsis and infections in Indian ICUs. Available at http: //goo.gl/12Dbhv. Accessed on December 18, 2014.

Bochud PY, Glauser MP, Calandra T. Antibiotics in sepsis. Intensive Care Med. 2001;27:S33-48.

Ferrer R, Artigas A, Suarez D, Palencia E, Levy MM, Arenzana A, et al. Effectiveness of treatments for severe sepsis: a prospective, multicenter, observational study. Am J Respir Crit Care Med. 2009;180:861-6.

Garnacho-Montero J, Garcia-Garmendia JL, Barrero-Almodovar A, Jimenez Jimenez FJ, Perez-Paredes C, Ortiz-Leyba C. Impact of adequate empirical antibiotic therapy on the outcome of patients admitted to the intensive care unit with sepsis. Crit Care Med. 2003;31:2742-51.

Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M. Early goal-directed therapy collaborative group. Early goal directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345:1368-77.

Bush K. New β-lactamases in gram-negative bacteria: diversity and impact on the selection of antimicrobial therapy. Clin Infect Dis. 2001;32:1085-9.

Witte W, Mielke M. β-Laktamasenmitbreitem Wirkungsspektrum. Bundesgesundheitsbl-Gesundheitsforsch-Gesundheitschutz. 2003;46:881-90.

Jacoby GA, Munoz-Price LS. The new beta-lactamases. N Engl J Med. 2005;352:380-91.

Paterson DL, Bonomo RA. Extended-spectrum b-lactamases: a clinical update. Clin Microbiol Rev. 2005;18:657-86.

Kattan JN, Villegas MV, Quinn JP. New developments in carbapenems. Clin Microbiol Infect. 2008;14:1102-11.

Köksal N, Hacimustafaoğlu M, Bağci S, cCelebi S. Meropenem in neonatal severe infections due to multiresistant gram-negative bacteria. Indian J Pediatr. 2001;68(1):15-9.

Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. American J Respir Critl Care Med. 2005;171(4):388-416.

Duszyńska W. Strategies of empiric antibiotic therapy in severe sepsis. Anaesthesiol Intensive Ther. 2012;44(2):96-103.

Sundaram S. Antibiotic use in critical care. Available at www.nes.scot.nhs.uk/ media/ 2575124/ antibiotic_use_in_critical_care.ppt. Accessed on 20 December 2014 at 3 pm.