Oceana Biomedicina Journal
Vol 1, No 2 (2018): Oceana Biomedicina Journal

Empirical Antibiotic Therapy Assessment of Patients diagnosed with Sepsis in Intermediate Care Ward of Internal Medicine Department of Dr. Soetomo General Hospital according to Gyssens Method

Adiwinoto, Ronald Pratama ( Airlangga University )
Sustini, Florentina ( Section of Epidemiology, Department of Public Health and Preventive Medicine, , Airlangga University School of Medicine, Surabaya )
Hardiono, Hardiono ( Critical Care Medicine, Department of Anesthesiology and Reanimation, Dr. Soetomo General Hospital, Surabaya )
Widodo, Agung Dwi Wahyu ( Head of Master Program of Immunology Department, Airlangga University School of Medicine, Surabaya )
Hidajat, Boerhan ( Professor of Clinic, Infection Prevention and Control, Department of Pediatric, Dr. Soetomo General Hospital Surabaya )
Hadi, Usman ( Professor of Clinic, Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Dr. Soetomo General Hospital Surabaya )



Article Info

Publish Date
20 Jul 2018

Abstract

Rational empirical antimicrobial therapy is an important component of sepsis patient management. This study aimed to assess the rationality of empirical antimicrobial therapy in patients diagnosed with sepsis admitted in intermediate care ward of internal medicine department (RPI) of Dr. Soetomo General Hospital from January 2016 to July 2017. Medical records of 91 patients diagnosed with sepsis were collected and studied retrospectively in period from July 2017 to November 2017. 91 (85.05%) medical records from 107 sepsis patients were evaluated. Cultures and antimicrobial sensitivity tests were carried out in 21 (23.07%) patients. 14 patients yielded positive culture results, 9 of which were MDRO positive with ESBL as resistant marker. Empirical antibiotic therapies for these patients were reviewed according to Gyssens method.73 (80.2%) of 91 patients were deemed receiving appropriate empirical antibiotic therapies. Ceftriaxone IV injection as monotherapy or combination therapy were the most common empirical antibiotic therapies (82 in 91 patients, 90.1%), despite local microbiologic flora and antibiogram show most pathogens were resistant to ceftriaxone. Mortality rate in this study was high, 92.3% (84 patients died) despite rational empirical antibiotic therapies were high. This study concluded that empirical antibiotic therapies in sepsis patients according to guidelines adopted in Soetomo General Hospital, albeit deemed rational, was no longer appropriate according to local antibiogram issued by microbiological department of Soetomo General Hospital. Keywords: Empirical Antibiotics Therapy, Gyssens criteria, Intermediate Care Ward, Sepsis, Septic Shock

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Journal Info

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journal

Publisher

Subject

Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Public Health

Description

Hyperbaric medicine, marine medicine other than hyperbaric, on ships, boats and harbor health, maritime and coastal health, medicolegal aspects and medicolegal related to ships, ports and districts / maritime / coastal communities and fishermen, epidemiological aspects of diseases, disabilities and ...