PURPOSE: 1. To determine the microbiology and outcomes of patients with hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). 2. To determine the attitudes of physicians on antibiotic use given the results of semiquantitative cultures of respiratory specimens.
METHODS: This is a cross-sectional cohort study involving 42 adult patients admitted at the central intensive care unit (ICU)between May 1, 2006 and July 31, 2006 who were diagnosed with HAP or VAP. Attitudes of the physicians in selection of antibiotics given the semiquantitative culture results of respiratory specimens as well as the in-hospital mortality, length of ICU stay, and response to antibiotics were recorded.
RESULTS: The most common pathogens isolated were Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumanii. Seventy-six percent of patients received culture-guided treatment. There was resolution of pneumonia in ninety-one percent of patients who received culture-guided treatment while pneumonia resolved in seventy-one percent of cases who received antibiotic other than the semiquantitative culture results. All-cause mortality was 10% for culture-guided group and 28.5% in non culture-guided group. The average ICU stay was 23 days and 31 days for culture-guided and non culture-guided groups respectively.
CONCLUSION: The study justifies the use of semi-quantitative respiratory cultures in the selection of proper antibiotic therapy in patients with nosocomial pneumonia.
CLINICAL IMPLICATIONS: In hospital settings where only semiquantitative cultures are available, it has been shown in this study that physicians can still rely on its results regarding the choice of antibiotic coverage for the patient. As has been mentioned, failure to follow the semiquantitative culture results can lead to increased ICU stay and mortality.
DISCLOSURE: Judith Sanico-Soliano, No Financial Disclosure Information; No Product/Research Disclosure Information