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Category: Volume 07 Issue 02 February 2019
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Title: Antibiotic Audit in Cases of Septicemia in Medical Intensive Care Unit (MICU) in a Tertiary Care Hospital in Mumbai

Authors: Anuradha S De, Nazneen I Malak, Jayanthi S Shastri

 DOI: https://dx.doi.org/10.18535/jmscr/v7i2.114

Abstract

Introduction: Intensive care units (ICU) are epicenters for the emergence of antibiotic resistance. Overprescribing and misuse of antibiotics are contributing to the development of multidrug resistance (MDR). Hence, this study was carried out to ensure the best clinical outcome for the patient while lowering the risk of antimicrobial resistance.

Aim and Objectives: To identify microorganisms from clinically suspected cases of septicemia in MICU, their antimicrobial susceptibility pattern and to evaluate the rational use of antibiotics.

Materials and Methods: A retrospective study was carried out in a tertiary care hospital for a period of one and a half years. Blood samples were processed in BACTEC 9120 system. Flash positive samples were further processed to identify the organisms by standard techniques and antimicrobial susceptibility test (AST) was performed by Kirby Bauer Disc Diffusion Method on Mueller Hinton Agar.

Results: Total blood cultures received were 309, of which 22.6% showed growth. Commonest species isolated was Acinetobacter spp. (34.3%), followed by Staphylococcus aureus (14.3%) and Escherichia coli (12.9%).MDR and carbapenem resistance were seen in 25% Enterobacteriaceae. MDR in non-fermenters was 50%, whereas carbapenem resistance was 63.3%. Fifty percent Staphylococcus spp were Methicillin resistant and 25% of Enterococci were Vancomycin resistant. On admission, the patients were empirically started on ceftriaxone and amoxicillin-clavulaunic acid. 63% of these patients were later escalated to Carbapenem/Vancomycin, based on the AST reports.

Conclusion: Prospective audit with feedback gives the proper direction to the clinicians and also helps us in formulating antimicrobial policy and revising the policy from time to time.

Keyword: Antibiotic audit, sepsis, antimicrobial resistance, MICU.

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Corresponding Author

Anuradha S De

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