*1Igunma, J. A., and 1,2Lofor, P. V. O.
1Department of Medical Microbiology, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
2Department of Medical Microbiology, University of Benin/University of Benin Teaching Hospital,
Benin City, Edo State, Nigeria
*Correspondence to: docigunma@gmail.com; +2348032690163
Abstract:
Background Early initiation of appropriate antibiotics is key to the effective management of severe bacterial infections. The initiation of targeted antibiotic therapy is possible only when the causative organism is isolated. As a result, antibiotics are usually administered on an empirical basis guided by the clinical presentation, local antibiotic guidelines and other relevant histories. Generally, empirical antibiotics differ for both community- and hospital-acquired infections (HAIs), as a result of which common HAI pathogens such as Pseudomonas aeruginosa should be deliberately targeted, because most routine antibiotics are ineffective against them.
Methodology: This was a retrospective cross-sectional study involving the review of the clinical consults sent to clinical microbiologists at the University of Benin Teaching Hospital (UBTH) between January and December 2022. The consults were analyzed for the initial diagnosis, reasons for the invitation and empirical antibiotics administered. Other relevant informations were obtained from the laboratory records. Susceptibility profiles of P. aeruginosa isolates were compared with the empirical antibiotics administered. Discordant empirical antibiotic therapy was defined as the administration of antibiotic regimen with no anti-pseudomonal activity.
Results: Of the 256 consults received over the period of study, P. aeruginosa was isolated from 57 (22.3%) patients as pathogens. Out of this, 24.6% (n=14) received at least one anti-pseudomonas antibiotic, which puts the total discordant rate at 75.4%. Metronidazole (22.7%) and ceftriaxone-sulbactam (Tandak) (21.5%) were the most commonly prescribed empirical antibiotics. The most common reason for consultation was a diagnosis of sepsis at 40.2% followed by pan-resistant isolates at 34.8%
Conclusion: Although the commonly prescribed antibiotics in our setting are broad spectrum, they lack coverage for P. aeruginosa which is one of the most common pathogens implicated in HAIs.
Keywords: Pseudomonas aeruginosa, discordant antibiotics, empiric antibiotics
Received Nov 6, 2023; Revised Dec 18, 2023; Accepted Dec 19, 2023
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