Inappropriate antibiotic use tied to extended ICU stay among pneumonia patients
Inappropriate prescription of anaerobic antibiotics to intensive care unit (ICU) patients admitted with pneumonia frequently occurs, with the prescription associated with prolonged length of stay (LOS) in the ICU, a study has found.
Researchers evaluated the practice patterns of anaerobic antibiotic use in 192 consecutive patients admitted to the ICU with aspiration pneumonia (Asp; n=20), community-acquired pneumonia (CAP; n=65) or healthcare-associated pneumonia (HCAP; n=107).
Anaerobic antibiotics were found to be given to 59 patients overall, including 18 with Asp, 11 with CAP and 30 with HCAP, although a significant proportion of these patients did not meet criteria to receive the antibiotics. Inappropriate anaerobic antibiotic use was reported in 12 patients in the Asp group, nine in the CAP group and 27 in the HCAP group.
Mortality probability model III at zero hours (MPM0) score and a diagnosis of Asp emerged as significant predictors of receiving inappropriate anaerobic antibiotics. Inappropriate anaerobic antibiotic use was particularly associated with an extended ICU stay (LOS, 7 days vs 4 days with nonuse; p=0.017).
The most common hospital-acquired infection in critically ill patients, pneumonia has prevalence rates ranging from 10 to 70 percent. It comprises 15 to 23 percent of all hospital-acquired infections and is associated with a high risk of mortality. [Indian J Pharm Sci 2015;77:299–305]
Antibiotics have been shown to be successful in the treatment of pneumonia. Nonetheless, successful antibiotic treatment involves several factors such as time of initiation, drug concentration and time of exposure. Appropriate initial antibiotic therapy is defined as antibiotic agents initially selected empirically based on local guidelines and Infectious Disease Society of America, but later supported by the antibiotic susceptibility tests. Additionally, appropriate antibiotic therapy should be administered at a correct dose, dosing interval and duration. [Am J Respir Crit Care Med 2005;171:388-416; Eur Respir Rev 2007;16:33–9; Chemotherapy 2005;51:171-6]