2023, Volume 29, Issue 1

THE EMPIRIC ANTIMICROBIAL THERAPY: THE COMPARISON OF INITIAL CHOICE WITH THE RESULTS OF MICROBIOLOGICAL INVESTIGATIONS. AN OBSERVATIONAL STUDY

DARIUSZ TOMASZEWSKI¹, ANETA GUZEK², ZBIGNIEW RYBICKI³
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¹Department of Anaesthesiology and Intensive Therapy, Military Institute of Aviation Medicine
²Section of Microbiology, Department of Laboratory Diagnostics, Military Institute of Medicine
³Department of Anaesthesiology and Intensive Therapy, Military Institute of Medicine


Autor korenspondencyjny: DARIUSZ TOMASZEWSKI; Department of Anaesthesiology and Intensive Therapy, Military Institute of Aviation Medicine; email: d.tomaszewski@wiml.waw.pl

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Streszczenie

Introduction: Hospital infections are serious medical problem, causing deterioration in patients’ outcome, prolonged hospital stay and increase costs of hospitalization. Rapid administration of wide spectrum antimicrobial agents is a well known way to increase patient survival rate. Aim: To analyze the efficacy of initial empiric antimicrobial treatment in a large academic hospital.

Methods: In this retrospective cohort study, the initial choice of empiric therapy was compared with the results of the microbiological investigation and the susceptibility/resistance of isolated pathogens.

Results: Between February 1, 2018 and February 1, 2020, a total number of 267 samples were analyzed. Amongst all 267 samples 163 (61%) were positive and 104 (39%) were negative. In those 163 samples 247 pathogens were isolated. In empirical therapy the most frequently administered antibiotic was meropenem (55/267, 20.6%), vancomycin (16/267, 6%), meropenem with vancomycin (14/267, 5.2%), ceftazidime (11/267, 4.1%), and imipenem/cilastatin (5/267, 1.9%).
The total number of samples where the empiric therapy corresponded with the results of microbiological tests was 166. There were forty-seven (28.3%) Gram positive bacteria, including 11 MRSA and 1 VRE, and 119 (71.7%) Gram negative pathogens, including 35 K. pneumoniae ESBL+, 12 A. baumannii, and 2 E. coli ESBL+.
In 81 cases, the isolated pathogens were resistant to empirically administered drugs.
The empiric antimicrobial therapy complied with the results of microbiological analyses in 67.2% (166/247) of cases.

Conclusion: In our center, meropenem and vancomycin seem to be a good choice in empiric therapy.

Słowa kluczowe

nosocomial infections, anti-bacterial agents, drug therapy, combination