238. Appropriate empirical Antimicrobial Treatment: A determinant in outcome of septic shock
Session: Poster Abstract Session: Diagnostic Microbiology
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • mani_2.pdf (706.5 kB)
  • Background: Septic shock is a leading cause of mortality in hospitals. Appropriate timely empirical antibiotics are vital for outcome for septic shock. This study aimed to see the impact of appropriateness of empirical antibiotics in patients who presented with septic shock.

    Methods: : We have conducted a prospective observational study from March 2012 to May 2012. During this period, patients diagnosed as Septic Shock as per the Surviving Sepsis Campaign Guidelines 2012 were divided into two groups: 1) Those treated with appropriate antibiotics; 2) Those treated with inappropriate antibiotics. Inappropriateness is defined as microbiological documentation of an infection that is not being effectively treated at the time of administration, absence of antibiotic against a specific class of microorganisms or the administration of an antimicrobial agent to which the microorganism was resistant. Results were analyzed using SPSS version 16.  P.Value of >0.05 was considered as significant

    Results:A total of 55 presented with septic shock among them 38 patients had microbiological documentation of infection (culture or serology) .These 38 patients were divided into two groups based on the appropriateness of empirical antibiotic therapy.24 (43.6%)patients had bacteremia, commonest organism being E.coli(29.1%).  Most common source infection was respiratory system (27.3%) followed by intra-abdominal sepsis (12.4%). Gram negative sepsis (70.8%) was more common than gram positive sepsis (29.2%). Median age and median APACHEII score were similar in both the groups (p=0.292, p=0.057 respectively).Inappropriate empirical antibiotic therapy was significantly associated with mortality (50% in appropriate group, 90% in inappropriate group; p=0.03).

    Conclusion :Lack of Administration of appropriate antibiotics will have poor outcome in septic shock. Hospitals should have a protocol for empirical use of antibiotics for septic shock

    Manideep Nandigam, STUDENT1, Danturulu Muralidhar Varma, MD2, Sudha Vidyasagar, MD3, Kalwaje Eshwara Vandana4 and Akash AJ1, (1)Kasturba Medical College , Manipal, MANIPAL, India, (2)Department of Medicine, Kasturba Medical College, Manipal University., Manipal Karnataka, India, (3)Medicine, Kasturba Medical College, Manipal Karnataka, India, (4)Kasturba Medical College, Manipal, India

    Disclosures:

    M. Nandigam, None

    D. M. Varma, None

    S. Vidyasagar, None

    K. E. Vandana, None

    A. AJ, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.