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ANALYSIS OF EMPIRICAL THERAPY IN VENTILATOR ASSOCIATED PNEUMONIA IN ICU IN PAKISTAN

Teyyaba Khan, Aleena Shahbaz, Shayaan Arshad

Introduction: Ventilator Associated Pneumonia is one of the common and fatal among Nosocomial infections that requires in time, appropriate and adequate antibiotic therapy. Mortality rates are greater in patients with ventilator associated pneumonia; the chances of mortality are maximum in bed ridden immune compromised patients in ICU. Objective: The objective of this study was the evaluation of Empirical therapy in suspected VAP cases in ICU patients. Methods: This prospective study was conducted in Bahawalpur Victoria Hospital during January 2019 to July 2019. The method involved pathogen identification, Antibiotic Sensitivity testing, hepatic, renal and hematological profiles and monitoring of Arterial blood gases of the patient. Pathogens from tracheal aspirates of the patients were subjected to commonly used antibiotics for their antibiograms. The prescribed antibiotics were evaluated by routine culture/sensitivity testing of tracheal aspirates and each patient was followed up to be assessed for the treatment progress. Effect of Antibiotic was evaluated for seven days by maintaining the record of the vital parameters of patients such as Temperature of the patient, PaO2, effect on leukocyte count, and from evaluation of LFTs and RFTs of the patient and chest radiograph obtained at the seventh day and keeping in view the overall disease status of the patient. Other outcomes were the mortality in these patients and the impact of inadequate empirical therapy on patient mortality. Also, to study the contribution of various risk factors upon VAP prognosis. Results: The microbial flora and their resistance pattern is a matter of great concern for adopting the strict infection control measures, hospital wise antibiotic policy formulation to reduce morbidity, mortality and to prevent the emergence of resistant pathogens. Conclusions: In this study, there was a high incidence of infection with resistant bacteria and inappropriate initial antibiotic therapy. Treatment failure due to inadequate antibiotics caused most mortality. Organ deterioration was also found to contribute to overall mortality in mechanically ventilated patients.

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