A Hospital Based Study on Empirical Use of Antibiotics in the Treatment of Lower Respiratory Tract Infections
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 2
Abstract
Background: Improving the care of adult patients with lower respiratory tract infections (LRTI) especially community-acquired pneumonia (CAP) has been the focus of many different organizations, and several have developed guidelines for management of CAP. The guidelines are mainly for emergency medicine physicians, hospitalists, and primary care practitioners. Every hospital should conduct an audit of the treatment protocols followed by their physicians at regular intervals. Aim of the Study: The aim of the study was to analyze the current trends in the selection of antibiotic empirically and their effectiveness in the treatment of LRTI in a tertiary teaching hospital. Materials and Methods: A total of 86 patients with the diagnosis of LRTI were included in this study. The severity of LRTI was assessed using the confusion, oxygen saturation, respiratory rate, and blood pressure (CORB) score. A point was given for each parameter to compute the total score. A CORB score of 0, 1, and >2 indicates mild, moderate, and severe CAP, respectively. Investigations done were Chest ‘‘X’’ ray, antibiotics received: (1) Antibiotics prescribed on admission, (2) route of AB administration, and (3) duration of ABs given. (4) If there is a switch from parenteral to oral therapy. (5) If there is a change of ABs group or not. (6) If yes to which group? (7) Duration and cause of such change were noted. Observations and Results: Among the 86 patients included in the study there were 51 (59.30%) males and 35 (40.69%) female patients. The mean age was 47.90 ± 9.48 years. The mean age among the males was 53.78 ± 6.45, and in females, the mean age was 49.85 ± 4.70 years. History of active smoking was present in 23/86 (26.74%), passive smoking in 14 (16.27%), and ex-smoker in 19 (22.09%) patients. The frequent antibiotic prescription used was broad-spectrum penicillins and cephalosporins (21) in all the LRTI patients amounting to 14/58 of CAP, 4/14 of chronic obstructive pulmonary disease, and 3/14 of bronchiectasis in this study. Conclusions: Empirical antibiotic prescription practices need to be well evaluated in a hospital to formulate an acceptable rationale aiming at improving the antibiotic usage. Awareness among the physicians about different widely accepted guidelines is necessary. The pharmacological audit should include patient compliance, patient demand, combination antibiotic therapy, and cost of treatment.
Authors and Affiliations
Sabir Cholas, Iftekhar Ahmed Nazeer
Keywords
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