Appropriateness of antibiotic therapy in sepsis patients in the intensive care unit: A single-center observational study
Abstract
Context: Sepsis remains a major cause of mortality in intensive care units, and antimicrobial selection is complicated by local resistance patterns.
Aims: To describe antimicrobial use and evaluate the association between guideline adherence and discharge outcomes among adult ICU patients with sepsis or septic shock.
Methods: A retrospective observational cohort study was conducted using 106 medical records from adult patients admitted to the ICU of Dong Nai 2 Hospital between January 2023 and February 2024. Empirical and post-susceptibility antimicrobial regimens were assessed according to the Sanford Guide and VNACCEMT 2020 recommendations.
Results: Respiratory infection was the most frequent source of sepsis. Cultures were performed in 63 patients, and blood cultures were positive in 32. The main pathogens were Klebsiella pneumoniae (38.1%), Acinetobacter baumannii (22.2%), Pseudomonas aeruginosa (14.3%), and methicillin-resistant Staphylococcus aureus (11.1%). Levofloxacin and piperacillin-tazobactam were commonly prescribed empirically, whereas meropenem, linezolid, and colistin were frequently used after susceptibility results. Empirical adherence to Sanford Guide and VNACCEMT recommendations was 32.1% and 56.6%, respectively. Post-susceptibility adherence was 46.4% and 50.0%, respectively. Adherence to the Sanford Guide after susceptibility testing was associated with treatment success at discharge, defined as recovery or improvement (OR 2.301, 95% CI 1.105–4.792; p =…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 63 participants or records.
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