A Prospective Observational Study on Antibiotic Usage Trends, Risk Factors and 28 Days Mortality Rate Associated With Ventilator-Associated Pneumonia Among Medical Icu Patients: Insights From a Tertiary Care Hospital

Abstract

Objective: This study was conducted to investigate the antibiotic usage, risk factors and mortality associated with the development of VAP (Ventilator Associated Pneumonia). Methods: An open–labelled, prospective, observational (case-control) study was carried out for 6 mo in the Department of Critical Care Medicine. Initial screening was done based on inclusion and exclusion criteria and 58 patients were found eligible. The statistical analysis was done using the Chi-Square test and t-test. Results: The incidence of VAP in our study was 6.07%. Prolonged hospitalisation (p=0.00) and ICU stay (p=0.00) showed a statistically significant association with the development of VAP and they possessed a high risk of carbapenem-resistant organisms in the age group more than 60 years. Colistin therapy alone and/or combined with tigecycline therapy showed 100% survival. SOFA (Sequential Organ Failure Assessment) scoring done before and after VAP diagnosis showed a significant difference (p<0.005). Our study revealed that mortality was high in patients with SOFA score range of 7-9. Conclusion: The lower incidence of VAP points out the good infection control practices in the ICU (Intensive Care Unit). Late-onset VAP was more prevalent with Acinetobacter baumannii. Prolonged hospitalization and ICU stay were the significant risk factors. Colistin therapy alone and/or in combination with tigecycline was the most effective treatment.