A prospective study on evaluation of antibiotics usage in patients with sepsis at a tertiary care hospital

H. S. Vanlalpeka; Blessy K. George; Balakeshwa Ramaiah

doi:10.18203/2319-2003.ijbcp20240382

Authors

H. S. Vanlalpeka Karnataka College of Pharmacy, Bangalore, Karnataka, India
Blessy K. George Department of Pharmacy Practice, Karnataka College of Pharmacy, Bangalore, Karnataka, India
Balakeshwa Ramaiah Department of Pharmacy Practice, Karnataka College of Pharmacy, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20240382

Keywords:

Sepsis, Antibiotics, Adverse drug reactions, Culture and sensitivity

Abstract

Background: Most developing countries are adopting antibiotic usage in sepsis. This study was conducted to evaluate the antibiotic usage in patients and to study medical adherence in high-risk patients. The study in particular aims to evaluate antibiotic usage in sepsis patients along with their related ADR’s. The study also aims to optimize the usage of antibiotics in high-risk patients at a tertiary care hospital.

Methods: Study was prospective and observational review of patients record in the hospital. Clinical notes, medication chart and electronic data management system at the hospital were used to analyse usage of antibiotics. Culture and sensitivity reports were obtained from relevant departments. Observations were then compiled and documented.

Results: Out of 40 cases collected 22 (55%) patients were male and 18 (45%) were female. Majority of the study population belongs to 71 years and above with 15 (37.5%) followed by age group of 41-60 years with 14 (35%). Most frequently prescribed antibiotics were found to be meropenem 16 (21.33%) and piperacillin tazobactam 14 (18.67%). The most resistant antibiotic was found to be cotrimazole in 35 (87.5%). ADRs were found in 35% of all cases.

Conclusions: Prescribing patterns for antibiotics need to be optimized. Adherence to and update of the policy is also recommended. It was found that the adherence to hospital antibiotic policy is low.

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References

Schinkel M, Paranjape K, Kundert J, Nannan Panday RS, Alam N, Nanayakkara PWB. Towards Understanding the Effective Use of Antibiotics for Sepsis. Chest. 2021;160(4):1211-21.

Polat G, Ugan RA, Cadirci E, Halici Z. Sepsis ve septik şok: Mevcut tedavi stratejileri ve yeni yaklaşımlar. Eurasian J Med. 2017;49(1):53-8.

Wang HE, Shapiro NI, Griffin R, Safford MM, Judd S, Howard G. Chronic Medical Conditions and Risk of Sepsis. PLoS One. 2012;7(10).

Pirozzi N, Rejali N, Brennan M, Vohra A, McGinley T, Krishna MG. Sepsis: Epidemiology, Pathophysiology, Classification, Biomarkers and Management. Educ Technol Soc. 2016;3(1):2-7.

A ATE, Gyawali B, Ramakrishna K, Dhamoon AS, Ortiz-Ruiz G, Duenas-Castell C et al. Diseases Original. SAGE Open Med. 2018;10(1):62.

Howell MD, Davis AM. Management of sepsis and septic shock. J Am Med Assoc. 2017;317(8):847-8.

Perner A, Haase N, Guttormsen AB, Tenhunen J, Klemenzson G, Åneman A et al. Hydroxyethyl Starch 130/0.42 versus Ringer’s Acetate in Severe Sepsis. N Engl J Med. 2012;367(2):124-34.

Caironi P, Tognoni G, Masson S, Fumagalli R, Pesenti A, Romero M et al. Albumin Replacement in Patients with Severe Sepsis or Septic Shock. N Engl J Med. 2014;370(15):1412-21.

Levy MM, Artigas A, Phillips GS, Rhodes A, Beale R, Osborn T et al. Outcomes of the Surviving Sepsis Campaign in intensive care units in the USA and Europe: A prospective cohort study. Lancet Infect Dis. 2012;12(12):919-24.

Kumar A, Zarychanski R, Light B, Parrillo J, Maki D, Simon D et al. Early combination antibiotic therapy yields improved survival compared with monotherapy in septic shock: A propensity matched analysis. Crit Care Med. 2010;38(9):1773-85.

Amarenco P, Bogousslavsky J, Callahan J 3rd, Goldstein LB, Hennerici M, Rudolph AE et al. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med. 2011;365(6):687-96.

Ferrer R, Martin-Loeches I, Phillips G, Osborn TM, Townsend S, Dellinger RP et al. Empiric antibiotic treatment reduces mortality in severe sepsis and septic shock from the first hour: Results from a guideline-based performance improvement program. Crit Care Med. 2014;42(8):1749-55.

Bernhard M, Lichtenstern C, Eckmann C, Weigand MA. The early antibiotic therapy in septic patients - milestone or sticking point? Crit Care. 2014;18(6):1-5.

Neill JO’. Antimicrobial Resistance: Tackling a crisis for the health and wealth of nations. The Review on Antimicrobial Resistance Chaired. 2014.

Ulldemolins M, Nuvials X, Palomar M, Masclans JR, Rello J. Appropriateness is Critical. Crit Care Clin. 2011;27(1):35-51.

Singer M, Deutschman CS, Seymour C, Shankar-Hari M, Annane D, Bauer M et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). J Am Med Assoc. 2016;315(8):801-10.

Seymour CW, Gesten F, Prescott HC, Friedrich ME, Iwashyna TJ, Phillips GS et al. Time to Treatment and Mortality during Mandated Emergency Care for Sepsis. N Engl J Med. 2017;376(23):2235-44.

Martínez ML, Plata-Menchaca EP, Ruiz-Rodríguez JC, Ferrer R. An approach to antibiotic treatment in patients with sepsis. J Thoracic Dis AME Publishing Company. 2020;12:1007-21.

Busch LM, Kadri SS. Antimicrobial treatment duration in sepsis and serious infections. Vol. 222. J Infect Dis Oxford University Press. 2020;S142-55.

Wang HE, Shapiro NI, Griffin R, Safford MM, Judd S, Howard G. Chronic Medical Conditions and Risk of Sepsis. PLoS One. 2012;7(10):1-7.

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(9):861-6.

Pradipta IS, Sodik DC, Lestari K, Parwati I, Halimah E, Diantini A et al. Antibiotic resistance in sepsis patients: Evaluation and recommendation of antibiotic use. N Am J Med Sci. 2013;5(6):344-52.

Macarthur RD, Miller M, Albertson T, Panacek E, Johnson D, Teoh L et al. Adequacy of Early Empiric Antibiotic Treatment and Survival in Severe Sepsis: Experience from the MONARCS Trial. Clin Infect Dis. 2004;38(2):284-8.

Mccabe WR, Jackson GG. Gram-Negative Bacteremia. II. Clinical, Laboratory, and Therapeutic Observations. JAMA Internal Med. 1962;110(6):856-64.

Shehab N, Patel PR, Srinivasan A, Budnitz DS. Emergency department visits for antibiotic‐associated adverse events. Clin Infect Dis. 2008;47(6):735-43.

Kiguba R, Karamagi C, Bird SM. Antibiotic‐associated suspected adverse drug reactions among hospitalized patients in Uganda: a prospective cohort study, Pharma Res Per. 2017;5(2):e00298.

Van der Hooft CS, Dieleman JP, Siemes C, Aarnoudse AJ, Verhamme KM, Stricker BH et al. Adverse drug reaction‐related hospitalisations: a population‐based cohort study. Pharmacoepidemiol Drug Saf. 2008;17(4):365-71.

Sonal Sekhar M, Adheena Mary C, Anju PG, Hamsa NA. 2011. Study on drug related hospital admissions in a tertiary care hospital in South India. Saudi Pharm J. 2011;19(4):273-8.