Precision medicine and patient outcomes in intensive care unit: Culture sensitivity, antibiotics, and APACHE score IV

Abstract

BACKGROUND: In the intensive care unit (ICU), complex medical conditions require specialized care; the threat of antibiotic resistance is significant due to frequent antibiotic use. This study investigates the pivotal role of culture sensitivity testing in shaping antibiotic prescription practices and patient outcomes in ICUs. MATERIALS AND METHODS: By using a prospective observational-analytical design, medical data from 640 patients at a Karachi hospital for one year in 2022 were utilized. The study focused on antibiotic therapy, including empiric and targeted approaches, culture sensitivity testing, the use of the APACHE scale for mortality prediction, and changes in antibiotic regimens based on culture reports. Statistical analysis involved Fisher’s Exact and ANOVA tests. RESULT: The age category above 60 emerged with the highest survivorship. Contrary to expectations, age did not seem to correlate significantly with mortality rates. Staphylococcus species was the most prevalent microorganism in this study, disproportionately affecting nonsurvivors 66.7%. The clinical profile comparison between survivors and nonsurvivors offered a multifaceted perspective, with significant differences in vital parameters such as temperature, heart rate, respiratory rate, urine output, FiO2, mean arterial pH, and blood sugar levels. Survivors (44.60%) underwent complete antibiotic regimen changes, a strategy for improved patient outcomes. CONCLUSIONS: Complex antibiotic combinations were prescribed for broad clinical conditions. These insights pave the way for future research on antibiotic stewardship in ICUs, navigating more effective and targeted treatments.