Effect of blood culture reports on antibiotics use by physicians in septic patients of intensive care unit

Choudhary, Sudhanshu; Yadav, Arvind Kumar; Sharma, Sanjeev Kumar; Pichholiya, Meenu; Sharma, Puneet

doi:10.18203/2320-6012.ijrms20150642

Cited by 5 publications

(24 citation statements)

References 12 publications

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“…In our current study, most common microorganism isolated from the patient's sample was gram-positive MSSA, with similar results seen in other studies [20,21,51]. However, in other studies, gram negative bacteria appear more common that gram-positive bacteria [32].…”

Section: Discussionsupporting

confidence: 90%

“…In our study, most of the patients were suffering from bone diseases and mostly MSSA or gram-positive bacteria were involved in osteomyelitis and in bone infections [52]. The second most common bacteria found in our study was E. coli, similar to another study conducted in a tertiary care hospital in India [20] but different from another study conducted in England [21].…”

Section: Discussionsupporting

confidence: 62%

“…Effective antimicrobial therapy depends on the early identi cation of causative microbes through culture sensitivity testing and the appropriate selection of antibiotics according to the results [11,17,18]. However, due to the threat of multidrug resistant hospital-acquired infections and for the coverage of multiple microbes, typically broadspectrum are started as an empirical therapy [11,[19][20][21]. In order though to reduce unnecessary use of antibiotics and treatment costs, as well as to avoid rising AMR rates, empirical therapy should subsequently be adjusted according to the result of culture sensitivity reports [11,[22][23][24][25][26].…”

Section: Introductionmentioning

confidence: 99%

“…Typically though, the results of blood cultures are often ignored because the patients show a therapeutic response to empiric therapy; however, this is not always the case [20,21,25]. Against this, antimicrobial stewardship programmes (ASPs) have been developed in hospitals to improve future antibiotic utilization and reduce subsequent AMR rates [16,[27][28][29].…”

Section: Introductionmentioning

confidence: 99%

“…However to date, there is limited information regarding the extent to which culture sensitivity reports help physicians in the selection of the most appropriate antibiotic treatment especially in lower and middle income countries (LMICs) where resources are more limited [21,32]. In one study in India, it was concluded that result of blood culture reports had a limited effect on the narrowing of antibiotics and the underutilization of culture sensitivity reports was observed in a study in England [20,21] as well as Ghana where patients in the public system had to pay for sensitivity testing [33]. Choudhary et al also found that a change of therapy was only undertaken in 20.9% of positive culture patients.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Culture Sensitivity Reports on the Pattern of Antibiotics use and Cost of Therapy: A Prospective Observational study

Altaf

Akhtar

Ahmad

et al. 2020

Preprint

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Background: There are concerns with inappropriate prescribing of antibiotics in hospitals especially broad spectrum in Pakistan and the subsequent impact on antimicrobial resistance rates. One recognized way to reduce inappropriate prescribing is for empirical therapy to be adjusted according to the result of culture sensitivity reports.Objective: To find the impact of culture sensitivity reports on the use of antibiotics and cost in a leading tertiary care hospital in Lahore.Methods: This prospective observational study was carried out in Ghurki trust teaching hospital. A total of 465 positive culture patients were taken over an 8 month study period using convenient sampling techniques and immediately sent to the microbiology laboratory for pathogen identification and susceptibility testing using the Kirby-Bauer disc diffusion method. Additional data was collected from the patient medical file which included demographic data, sample type, causative microbe, anti-microbial treatment given in empirical and definitive treatment as well as medicine costs. Results: Total of 497 isolates were detected from the 465 patient samples, which included 309 gram-negative rods and 188 gram-positive cocci. Out of 497 isolates, the most common Gram-positive pathogen isolated was MSSA (28.4%) and Gram-negative was E. coli (23.8%). Most of the gram-negative isolates were found to be resistant to ampicillin and co-amoxiclav. Most of the A. baumannii isolates were resistant to carbapenems. Gram-positive microorganism showed the maximum sensitivity to linezolid and vancomycin. The most widely used antibiotics in empirical therapy were cefoperazone+sulbactam, ceftriaxone, amikacin, vancomycin and metronidazole whereas high use of linezolid, clindamycin, meropenem and piperacillin + tazobactam was evidenced in definitive treatment. Empiric therapy was adjusted in 222 (71.8%) cases of Gram-negative infections and 131 (69.6%) cases of gram-positive infections (p-value <0.0001). Compared with empirical therapy, there was a 13.8% reduction in the number of antibiotics in definitive treatment. The average costs of antibiotics in definitive treatment was less than the empirical treatment (8.2%) and the length of hospitalization also decreased.Conclusion: Culture sensitivity reports helped reduce antibiotic utilization, hospital stay and costs as well as helping select the most appropriate treatment. We also found an urgent need for implementing antimicrobial stewardship programs and the development of hospital antibiotic guidelines within the hospital to reduce future unnecessary prescribing of broad-spectrum antibiotics.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of Culture Sensitivity Reports on the Pattern of Antibiotics use and Cost of Therapy: A Prospective Observational study

Altaf

Akhtar

Ahmad

et al. 2020

Preprint

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Appropriateness of Antibiotics Use and Associated Factors in Hospitalized Patients at University of Gondar Specialized Hospital, Amhara, Ethiopia: Prospective Follow-up Study

Anteneh

Kifle

Mersha

et al. 2021

INQUIRY

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Background: Appropriate antibiotic use means that the patient receives the appropriate drug at adequate doses and duration for a susceptible pathogen. This improves the effectiveness of antibiotic therapy and prevents the emergence of resistant pathogens. Thus, this study aimed to assess the appropriateness of antibiotics use and associated factors among hospitalized patients. Methods: A hospital-based prospective follow-up study was conducted in internal medicine. Data were collected by chart review and interview of prescribers and patients using a pre-tested questionnaire derived from RAND modified Delphi method. Appropriate antibiotic use means that the patient receives the drug based on culture result at the right time in adequate doses and duration. Frequencies and percentage distribution of dependent variables were analyzed. Moreover, bivariate and multivariate analyses were used to assess the factors influencing factors. Result: Of the 303 study participants, the mean age was44.36 ± 1.07 years and the majority 173 (57.1%) of the participants were females. The appropriateness of antibiotics use among hospitalized patients was 26 (8.6%). Males have used antibiotics more appropriately than females [5.99 (Adjusted odd ration (AOR) 95% CI 2.00-7.98)], while employed study participants were used antibiotics more appropriately than nonemployees [7.29 (AOR 95% CI 1.34-9.58)]. Moreover, patients who received antibiotics after blood culture [2.74 (AOR 95% CI 1.09-8.37)] and cerebrospinal fluid culture [5.82 (AOR 95% CI 1.84-5.63)] were used antibiotics more appropriately than patients who received antibiotics without culture. In addition, patients who believe that the prescribed antibiotics prevent complication of the disease [4.21 (AOR 95% CI 1.33-7.35)] were used antibiotics more appropriately than those who didn’t understand the use of antibiotics. Conclusion: The appropriateness of antibiotics use was very low in the study area. Patient gender, ethnicity, source of income, patient’s belief in antibiotics, and specimen cultures were significantly associated with the appropriateness of antibiotics use.

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Impact of Culture Sensitivity Reports on the Pattern of Antibiotics use and Cost of Therapy: A Prospective Observational study

Altaf

Akhtar

Godman

et al. 2023

Preprint

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Effect of blood culture reports on antibiotics use by physicians in septic patients of intensive care unit

Cited by 5 publications

References 12 publications

Impact of Culture Sensitivity Reports on the Pattern of Antibiotics use and Cost of Therapy: A Prospective Observational study

Impact of Culture Sensitivity Reports on the Pattern of Antibiotics use and Cost of Therapy: A Prospective Observational study

Appropriateness of Antibiotics Use and Associated Factors in Hospitalized Patients at University of Gondar Specialized Hospital, Amhara, Ethiopia: Prospective Follow-up Study

Impact of Culture Sensitivity Reports on the Pattern of Antibiotics use and Cost of Therapy: A Prospective Observational study

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