Evaluation of Empirical Meropenem Bolus Protocol in Pseudomonas aeruginosa: A Three-Year Analysis in Tertiary Intensive Care Unit

I Wayan Suranadi,1 Putu Agus Surya Panji,1 Ni Nyoman Sri Budayanti,2 Tjokorda Gde Agung Senapathi,1 Arif Budiman Susatya1 1Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Udayana/Sanglah General Hospital, Denpasar, Bali, 80113, Indonesia; 2Department of Clinical Mic...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Suranadi IW, Panji PAS, Budayanti NNS, Senapathi TGA, Susatya AB
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	antibiotic resistance critical care empirical therapy indonesia meropenem pseudomonas aeruginosa Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/dcd880a6198e453ba7a4ce265ae49749
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:dcd880a6198e453ba7a4ce265ae49749
record_format	dspace
spelling	oai:doaj.org-article:dcd880a6198e453ba7a4ce265ae497492021-11-09T18:40:34ZEvaluation of Empirical Meropenem Bolus Protocol in Pseudomonas aeruginosa: A Three-Year Analysis in Tertiary Intensive Care Unit1178-7074https://doaj.org/article/dcd880a6198e453ba7a4ce265ae497492021-11-01T00:00:00Zhttps://www.dovepress.com/evaluation-of-empirical-meropenem-bolus-protocol-in-pseudomonas-aerugi-peer-reviewed-fulltext-article-IJGMhttps://doaj.org/toc/1178-7074I Wayan Suranadi,1 Putu Agus Surya Panji,1 Ni Nyoman Sri Budayanti,2 Tjokorda Gde Agung Senapathi,1 Arif Budiman Susatya1 1Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Udayana/Sanglah General Hospital, Denpasar, Bali, 80113, Indonesia; 2Department of Clinical Microbiology, Faculty of Medicine, Universitas Udayana, Denpasar, Bali, 80113, IndonesiaCorrespondence: I Wayan SuranadiDepartment of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Udayana/Sanglah General Hospital, Diponegoro Street, Dauh Puri Klod, Denpasar, 80113, IndonesiaTel/Fax +62361-227911Email wayan.suranadi@unud.ac.idPurpose: To describe meropenem empirical use, susceptibility trend, and associated factors for acquired nonsusceptibility in P. aeruginosa in the intensive care unit.Patients and Methods: This study was conducted in the intensive and high care unit of a tertiary care hospital in Indonesia to evaluate empirical meropenem bolus administration protocol. All patients admitted during the 3 year study period from January 2018 through January 2021 with culture-confirmed P. aeruginosa infection were included in the study. Primary data were collected from hospital database electronic medical record and series of local biannual report of microorganism susceptibility pattern.Results: The data suggested that there was increasing trend in meropenem nonsusceptibility and multidrug-resistance rates. A total of 135 patients with various primary diagnoses and comorbidities were studied. P. aeruginosa isolates were mostly (73.4%) obtained from sputum specimen. Empirical meropenem therapy was administrated in 24.4% of patients with standard- and high-dose as indicated. Nonsusceptibility was acquired in 37% patients who mostly received empirical therapy. Multivariable analysis revealed protocol being evaluated as a statistically significant risk factor for nonsusceptibility in P. aeruginosa (PR = 30.65; p < 0.001).Conclusion: Empirical meropenem administration protocol in this study was an independent determinant of nonsusceptibility acquisition in P. aeruginosa. These findings proved that empirical therapeutic strategy modification is indispensable and routine evaluation practice should be promulgated.Keywords: antibiotic resistance, critical care, empirical therapy, Indonesia, meropenem, Pseudomonas aeruginosaSuranadi IWPanji PASBudayanti NNSSenapathi TGASusatya ABDove Medical Pressarticleantibiotic resistancecritical careempirical therapyindonesiameropenempseudomonas aeruginosaMedicine (General)R5-920ENInternational Journal of General Medicine, Vol Volume 14, Pp 7861-7867 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	antibiotic resistance critical care empirical therapy indonesia meropenem pseudomonas aeruginosa Medicine (General) R5-920
spellingShingle	antibiotic resistance critical care empirical therapy indonesia meropenem pseudomonas aeruginosa Medicine (General) R5-920 Suranadi IW Panji PAS Budayanti NNS Senapathi TGA Susatya AB Evaluation of Empirical Meropenem Bolus Protocol in Pseudomonas aeruginosa: A Three-Year Analysis in Tertiary Intensive Care Unit
description	I Wayan Suranadi,1 Putu Agus Surya Panji,1 Ni Nyoman Sri Budayanti,2 Tjokorda Gde Agung Senapathi,1 Arif Budiman Susatya1 1Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Udayana/Sanglah General Hospital, Denpasar, Bali, 80113, Indonesia; 2Department of Clinical Microbiology, Faculty of Medicine, Universitas Udayana, Denpasar, Bali, 80113, IndonesiaCorrespondence: I Wayan SuranadiDepartment of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Udayana/Sanglah General Hospital, Diponegoro Street, Dauh Puri Klod, Denpasar, 80113, IndonesiaTel/Fax +62361-227911Email wayan.suranadi@unud.ac.idPurpose: To describe meropenem empirical use, susceptibility trend, and associated factors for acquired nonsusceptibility in P. aeruginosa in the intensive care unit.Patients and Methods: This study was conducted in the intensive and high care unit of a tertiary care hospital in Indonesia to evaluate empirical meropenem bolus administration protocol. All patients admitted during the 3 year study period from January 2018 through January 2021 with culture-confirmed P. aeruginosa infection were included in the study. Primary data were collected from hospital database electronic medical record and series of local biannual report of microorganism susceptibility pattern.Results: The data suggested that there was increasing trend in meropenem nonsusceptibility and multidrug-resistance rates. A total of 135 patients with various primary diagnoses and comorbidities were studied. P. aeruginosa isolates were mostly (73.4%) obtained from sputum specimen. Empirical meropenem therapy was administrated in 24.4% of patients with standard- and high-dose as indicated. Nonsusceptibility was acquired in 37% patients who mostly received empirical therapy. Multivariable analysis revealed protocol being evaluated as a statistically significant risk factor for nonsusceptibility in P. aeruginosa (PR = 30.65; p < 0.001).Conclusion: Empirical meropenem administration protocol in this study was an independent determinant of nonsusceptibility acquisition in P. aeruginosa. These findings proved that empirical therapeutic strategy modification is indispensable and routine evaluation practice should be promulgated.Keywords: antibiotic resistance, critical care, empirical therapy, Indonesia, meropenem, Pseudomonas aeruginosa
format	article
author	Suranadi IW Panji PAS Budayanti NNS Senapathi TGA Susatya AB
author_facet	Suranadi IW Panji PAS Budayanti NNS Senapathi TGA Susatya AB
author_sort	Suranadi IW
title	Evaluation of Empirical Meropenem Bolus Protocol in Pseudomonas aeruginosa: A Three-Year Analysis in Tertiary Intensive Care Unit
title_short	Evaluation of Empirical Meropenem Bolus Protocol in Pseudomonas aeruginosa: A Three-Year Analysis in Tertiary Intensive Care Unit
title_full	Evaluation of Empirical Meropenem Bolus Protocol in Pseudomonas aeruginosa: A Three-Year Analysis in Tertiary Intensive Care Unit
title_fullStr	Evaluation of Empirical Meropenem Bolus Protocol in Pseudomonas aeruginosa: A Three-Year Analysis in Tertiary Intensive Care Unit
title_full_unstemmed	Evaluation of Empirical Meropenem Bolus Protocol in Pseudomonas aeruginosa: A Three-Year Analysis in Tertiary Intensive Care Unit
title_sort	evaluation of empirical meropenem bolus protocol in pseudomonas aeruginosa: a three-year analysis in tertiary intensive care unit
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/dcd880a6198e453ba7a4ce265ae49749
work_keys_str_mv	AT suranadiiw evaluationofempiricalmeropenembolusprotocolinpseudomonasaeruginosaathreeyearanalysisintertiaryintensivecareunit AT panjipas evaluationofempiricalmeropenembolusprotocolinpseudomonasaeruginosaathreeyearanalysisintertiaryintensivecareunit AT budayantinns evaluationofempiricalmeropenembolusprotocolinpseudomonasaeruginosaathreeyearanalysisintertiaryintensivecareunit AT senapathitga evaluationofempiricalmeropenembolusprotocolinpseudomonasaeruginosaathreeyearanalysisintertiaryintensivecareunit AT susatyaab evaluationofempiricalmeropenembolusprotocolinpseudomonasaeruginosaathreeyearanalysisintertiaryintensivecareunit
_version_	1718440888651218944

Evaluation of Empirical Meropenem Bolus Protocol in Pseudomonas aeruginosa: A Three-Year Analysis in Tertiary Intensive Care Unit

Ejemplares similares