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- Title
Nosocomial pneumonia: Search for an empiric and effective antibiotic regimen in high burden tertiary care centre.
- Authors
Gupta, Nitin; Soneja, Manish; Ray, Yogiraj; Sahu, Monalisa; Sharada Vinod, Kutty; Kapil, Arti; Biswas, Ashutosh; Wig, Naveet; Sood, Rita
- Abstract
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.
- Subjects
PNEUMONIA treatment; ANTIBIOTICS; MULTIDRUG resistance; ACINETOBACTER baumannii; PSEUDOMONAS aeruginosa
- Publication
Drug Discoveries & Therapeutics, 2018, Vol 12, Issue 2, p97
- ISSN
1881-7831
- Publication type
Article
- DOI
10.5582/ddt.2017.01070