Impact of Empirical Antibiotics Therapy on the Clinical Outcomes of Adult Patients Admitted to the Intensive Care Units with Sepsis in Sudan Impact of emperical antibiotics on the clincal outcomes of adult patients admitted to the intensive care unit with sepsis

Abstract

Introduction: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to an infection. Early recognition and administration of appropriate empirical antibiotic therapy are associated with lower mortality rate and shorter length of stay. This study aims to identify the risk factors for developing sepsis, the common sites of infection, the isolated microorganisms, and to evaluate the impact of appropriate empiric antibiotic on the mortality rate and length of stay the in two tertiary care hospitals in Sudan. Methodology: A prospective hospital-based study was done on 30 patients who were admitted to the intensive care unit (ICU) during a four-month study period. Data were retrieved from patients’ records. Data were analyzed using SPSS Version 20. Results: Out of the 30 study patients, 43% were females. The median age of the group was 68 years and 57% of the patients were above 65 years. The most common risk factor for developing sepsis was diabetes mellitus (23.33%), followed by malignancy (16.67%). The most common site of infection was the chest (33.33%). In total, 19 different regimens of empirical antibiotics were prescribed, where 43.4% were appropriate and 56.6% were inappropriate. Among the studied population, 18 patients died and the overall mortality was 60%. The study found that in patients who received appropriate empiric antibiotics, mortality significantly decreased (p = 0.006). Patients who received appropriate treatment were also found to have a numerically 4-days shorter length of ICU stay but this did not reach statistical significance due to small sample size. Conclusions: The study concluded that diabetes mellitus is the most common risk factor for developing sepsis, followed by malignancy. Gram-negative organisms are the most common isolated microorganisms. Respiratory infection is the most common source of infections. The prescribed empirical antibiotics were mostly inappropriate. Moreover, patients with appropriate empirical antibiotics had shorter ICU stays and increased survival when compared with those who had inappropriate treatment.