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
DOI:
https://doi.org/10.30649/obj.v1i2.17Keywords:
Empirical Antibiotics Therapy, Gyssen criteria, Intermediate Care Ward, Sepsis, Septic ShockAbstract
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.
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