Quality Assesment of Antibiotic Prescription for Sepsis Treatment in Intensive Care Unit at Top Referral Hospital in West Java, Indonesia

Shadrina Dinan Adani, Ardi Zulfariansyah, Putri Teesa Radhiyanti Santoso

Abstract


Background: Sepsis is a common disease in intensive care unit (ICU) with high mortality rate. Administration of antibiotic has an important role to determine the outcome of sepsis patient. This study aimed to evaluate the quality of antibiotic prescription for sepsis treatment in intensive care unit (ICU).

Methods: This descriptive study was conducted by retrieving data from 48 medical records of patients with sepsis, severe sepsis, and septic shock admitted to ICU  Dr. Hasan Sadikin General Hospital (RSHS) in 2013. The study was conducted from August to October 2014. Empiric therapy in the ICUat RSHS and Surviving Sepsis Campaign (SSC) guidelines in 2012 were used as a standard for antibiotic prescription. The quality of antibiotic prescription was assessed then categorized based on Gyssens criteria. The collected data were analyzed in the form of frequency and percentage and presented in tables.

Results: This study discovered that most of the patients had severe sepsis and septic shock. Based on Gyssens criteria, 35% antibiotic uses were included into category 0 (proper); 1.4% category I (improper timing); 10.5% category IIA (improper dosage); 9.1% category IIB (improper interval); 3.5% category IIC (improper route); 12.6% category IIIA (improper duration; too long); 1.4% category IIIB (improper duration; too short); 16.8% category IVA (improper; other antibiotics were more effective); 4.2% category IVD (improper; other antibiotics had narrower spectrum); and 5.6% category V (improper; no indication).

Conclusions: There are still improper uses of antibiotic for sepsis, severe sepsis, and septic shock patients in the ICU.

 

DOI: 10.15850/amj.v4n2.1088


Keywords


Antibiotic, Glyssens criteria, sepsis, septic shock, severe sepsis

Full Text:

PDF

References


Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013;41(2):580–635.

Vincent JL, Sakr Y, Sprung CL, et al. Sepsis in European intensive care units: results of the SOAP study. Crit Care Med. 2006;34(2):344–353.

Esteban A, Frutos-Vivar F, Ferguson N, Penuelas O, Lorente JA, Gordo F, et al. Sepsis incidence and outcome: Contrasting the intensive care unit with the hospital ward*. Crit Care Med. 2007;35(5):1284–9.

Blanco J, Muriel-Bombin A, Sagredo V, Taboada F, Gandia F, Tamayo L, et al. Incidence, organ dysfunction and mortality in severe sepsis: a Spanish multicentre study. Crit Care. 2008;12(6):R158.

Herald Napitupulu. Sepsis. The Indonesian J Anesth Crit Care. 2011;28(3):207–15.

Van der Meer JWM, Gyssens IC. Quality of antimicrobial drug prescription in hospital. Clin Microbiol Infect. 2001;7(6):12–15.

Martin GS, Mannino DM, Moss M. The effect of age on the development and outcome of adult sepsis. Crit Care Med. 2006;34(1):15–21.

NHMRC.Prevention and control of infection in residential and community aged care.Canberra: Department of Health and Ageing; 2013.

Aulock SV, Deininger S, Draing C, Gueinzius K, Dehus O, Hermann C. Gender difference in cytokine secretion on immune stimulation with LPS and LTA. J InterferonCytokine Res. 2006;26(12):887–92.

Hochreiter M, Köhler T, Schweiger AM, Keck FS, Bein B, Von Spiegel, et al. Procalcitonin to guide duration of antibiotic therapy in intensive care patients: a randomized prospective controlled trial. Crit Care. 2009;13(3):R83.

Iwan Dwiprahasto. Kebijakan untuk meminimalkan risiko terjadinya resistensi bakteri di unit perawatan intensif rumah sakit. Jurnal Manajemen Pelayanan Kesehatan. 2005;8(4):177–81.

Pea F, Viale P. Bench-to-bedside review: appropriate antibiotic therapy in severe sepsis and septic shock - does the dose matter. Crit Care. 2009;13(3):R214.

Garnacho-Montero J, Garcia-Garmendia JL, Barrero-Almodovar A, Jimenez-Jimenez FJ, Perez-Paredes C, Ortiz-Leyba C. Impact of adequate empirical antibiotic therapy on the outcome of patients admitted to the intensive care unit with sepsis. Crit Care Med. 2003;31(12):2742–51

Kumar A, Ellis P, Arabi Y, Roberts D, Light B, Parrillo JE, et al. Initiation of inappropriate antimicrobial therapy results in a fivefold reduction of survival in human septic shock. CHEST J. 2009;136(5):1237–48.




DOI: http://dx.doi.org/10.15850/amj.v4n2.1088

Refbacks

  • There are currently no refbacks.



 

This Journal indexed by:

               

 

Creative Commons License
AMJ is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

 


View My Stats