The efficacy of empirical antibiotic treatment and resistance on mortality in an internal medicine intensive care unit
Mustafa Sadeçolak1, Alihan Oral2, Abdülkadir Kocanoğlu3, Mehemet Uzunlulu4
1Department of Gastroenterology, Sakarya University, Faculty of Medicine, Sakarya, Turkey
2Department of Internal Medicine, Medicana Bahçelievler Hospital, Istanbul, Turkey
3Department of Oncology, Ankara Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
4Department of Internal Medicine, Medeniyet University, Göztepe Training and Research Hospital, Istanbul, Turkey
Keywords: Antibiotic resistance, infection, intensive care, mortality
Objectives: This study aimed to determine the efficacy and resistance of empirical antibiotics (EA) in patients admitted to the Internal Medicine Intensive Care Unit (ICU) due to community-acquired infections according to the infectious agents in the follow-up of patients and to determine its relationship on mortality.
Patients and methods: A total of 162 patients (78 males, 84 females; mean age 74.7±13.5 years; range 22 to 98 years) with community-acquired infections, followed in Medeniyet University, Göztepe Training and Research Hospital Internal Medicine Intensive Care Unit between March 2015 and March 2017, were included in this study. The patients’ age, sex, comorbidities, diagnoses, EA, culture antibiogram, and mortality outcomes were all recorded retrospectively.
Results: The most common (50%) comorbidity was hypertension. The common diagnosis on admission was pneumonia (46.2%). Acinetobacter Baumannii was the most isolated bacterium. The most frequently used group of EA was carbapenems (46.9%). Culture antibiogram results showed resistance to the EA in 42.6% of the patients. Empirical antibiotics were replaced with other antibiotics in 46.9% of the patients. When compared to the susceptible group, mortality was higher in the resistant group to the EA.
Conclusion: In this study; antibiotic resistance was found to affect mortality in patients admitted to the Internal Medicine ICU for community-acquired infections.