Influence of blood culture and sensitivity results on the antibiotic choices of attending physicians in the management of bacteremia

Abstract:

This retrospective and descriptive study was undertaken to determine the influence of positive blood culture and sensitivity tests on the antibiotic choice of attending physicians at the UERMMMC. Fifty eight patients with positive blood cultures were included, of which 38 (65.5%) of isolates were gram (-) with Salmonella occurring as the most common pathogen (31%). Among the secondary bacteremias, the most common sites of origin were the urinary and lower respiratory tracts. Empiric therapy was started on majority of patients, with 89% given monotherapy. Initial therapy was primarily influenced by the admitting impression of the attending physicians. Of the 58 patients, 29 were discharged prior to the release of blood C/S results. All were on empiric therapy and evaluation of antibiotics showed only 13.7% were used appropriately. Of the 29 patients discharged after the release of blood C/S results, 27 were on empiric antibiotics. Two attending physicians modified their empiric treatment (7.2%) with only 1 modification evaluated as appropriate. Of the physicians who did not modify treatment, only 5 (20%) antibiotic treatments were appropriate. Two patients were not on empiric therapy (6.9%). Antibiotics were started after release of blood C/S and only one was evaluated as appropriate. Our study shows the blood culture and sensitivity test results have a limited effect on the antibiotic choices of attending physicians in our institution.(Phil J Microbiol Infect Dis 1998; 27 (1): 28-32)

Año de publicación:

1995

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