DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20200187

Antibiotic regimens utilization in treating community acquired pneumonia of a government practice setting: a prospective observational study in medical inpatients

K. Leela Prasad Babu, Shaik Kareemulla, S. K. Sai Pravalika, P. Nishad Khan, Govindu Venkateswarlu, K. Sreeharinadh

Abstract


Background: Pneumonia is a lower respiratory tract infection characterized by inflammation of lung tissue accompanied by infiltration of alveoli and bronchioles. Most common type is community acquired pneumonia (CAP). Initial therapy is usually empirical that is designed to treat various pathogens. In CAP cases, antibiotic therapy should begin at the earliest. The objectives of the study include to identify most common causative micro-organisms, to assess risk of developing CAP in patients having co-morbidities, to identify most commonly prescribed antibiotic regimen.

Methods: A prospective observational study was conducted for period of 6 months at RIMS, Kadapa. 120 patients were recruited based on inclusion criteria. Treatment was given according to Infectious Diseases Society of America and American Thoracic Society guidelines.

Results: In a total of 120 patients, 77 were males and 43 were females. 69 patients belong to 46-55 & above age groups. 84 patients had social habits and 36 patients are without social habits. Patients with single lobe infiltrations are 105 and patients with multiple lobe infiltrations are 15. In our study, streptococcus pneumoniae and pseudomonas aeruginosa were the most common isolated organisms. Monotherapy was given for 7 patients, dual therapy for 97 patients and triple therapy for 16 patients. 33 patients received ceftriaxone (CEF) and augmentin (AUG), 29 patients received CEF and azithromycin (AZI), 7 patients received levofloxacin (LEV), 25 patients received CEF and LEV, 10 patients received CEF and ciprofloxacin (CIP) and 16 patients received CEF, AUG and AZI. 100 patients had less than 8 days of hospital stay.

Conclusions: Research study concluded that β lactum antibiotics were the most commonly prescribed class. CEF and AUG was highly recommended drug regimen.


Keywords


Streptococcus pneumonia, Empirical therapy, Inflammation, Bronchioles

Full Text:

PDF

References


Walker R, Whittlesea C. Clinical pharmacy and therapeutics. 5th edition. Churchill Livingstone Elsevier; 2014: 550-552.

Niederman MS, Craven DE, Bonten MJ, et al. American Thoracic Society, Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired (HAP), ventilator-associated (VAP) and healthcare-associated pneumonia; Am J Res Cri Care Med. 2005;17(1);388-416.

Jain S, Williams DJ. Community acquired pneumonia requiring hospitalization among U.S. adults. N Engl J Med. 2015;373(5):415-27.

Walker B, Colledge NR, Ralston S, Penman I. Davidson’s principles and practice of medicine. 22nd edition. Churchill Livingstone, Elsevier; 2014: 682-685.

Dev Y. Pathophysiology of community acquired pneumonia. JAPE. 2012;60(1):8-9.

Moore M, Stuart B, Little P, Smith S, Thompson MJ, Knox K, et al. Diagnosis of pneumonia in lower respiratory tract infections;3c prospective cough complication cohort study. Europe Respire J. 2017;50(3):151-3.

Dan LL, Antbony FS, Dennis LK, Stephen LH, Larry JJ. Harrison’s principle of internal medicine, 18thedition. Volume 2. The McGraw-Hill companies; 2011: 2134-5.

Saeed MS, Aldakheel BA. Prescribing Patterns of Antibiotics for Community-Acquired Pneumonia in Adult in King Saud Hospital. British J Med Medical Res. 2017;20(5):1-8.

Siddalingappa CM, Kalpana L, Puli S, Vasudha TK, Acharya A. Sensitivity pattern of bacteria causing respiratory tract infections in a tertiary care centre. Int J Basic Clin Pharmacol. 2013;2:590-5.

Kumar S, Agrawal D, Santra S, Dehury S, Das P, Swain T. Prescribing pattern of antibiotics in community-acquired pneumonia in a teaching hospital of Southeast Asia; J Health Res Rev. 2015;2(3):86.

Fatima A, Naqvi SB, Khaliq SA, Perveen S, Jabeen S. Antimicrobial susceptibility pattern of clinical isolates of Pseudomonas aeruginosa isolated from patients of lower respiratory tract infections. Springer Plus. 2012;70:12-24.

Taura DW, Hassan A, Yayo AM, Takalmawa H. Bacterial isolates of the respiratory tract infection and their current sensitivity pattern among patients attending Aminu Kano Teaching Hospital Kano-Nigeria. Int Res J Microbiol. 2013;4(9):226-31.

Ramana KV, Kalaskar A, Rao M, Rao SD. Aetiology and Antimicrobial Susceptibility Patterns of Lower Respiratory Tract Infections (LRTI’s) in a Rural Tertiary Care Teaching Hospital at Karimnagar, South India. Am J Infec Dis Microbiol. 2013;1(5):101-5.

Zafar A, Hussain Z, Lomama E, Sibiie S, Irfan S, Khan E. Antibiotic susceptibility of pathogens isolated from patients with community-acquired respiratory tract infections in Pakistan-the active study. J Ayub Med Coll Abbottabad. 2008;20(1):7-9.

Meng TSE, Lee SH, Chang SS, Chan YL, Pang L, Hsu SM, et al. Comparative treatment failure rates of respiratory fluoroquinolones or β-Lactam alone in the treatment for community acquired pneumonia in adult outpatients. Medicine. 2015;94(39):1662.

Okesola AO, Ige OM. Trends in Bacterial Pathogens of Lower Respiratory Tract Infections. Indian J Chest Dis Allied Sci. 2008;50:269-72.

Li JZ, Winston LG, Moore DH. Bent Efficacy of short-course antibiotic regimens for community-acquired pneumonia; A meta-analysis. Am J Medicine. 2007;120(9):783-90.