Ventilator-associated pneumonia: the influence of bacterial resistance, prescription errors, and de-escalation of antimicrobial therapy on mortality rates
Braz. j. infect. dis
; 20(5): 437-443, Sept.-Oct. 2016. tab
Article
in En
| LILACS
| ID: biblio-828144
Responsible library:
BR1.1
ABSTRACT
Abstract Ventilator-associated pneumonia is the most prevalent nosocomial infection in intensive care units and is associated with high mortality rates (14–70%). Aim This study evaluated factors influencing mortality of patients with Ventilator-associated pneumonia (VAP), including bacterial resistance, prescription errors, and de-escalation of antibiotic therapy. Methods This retrospective study included 120 cases of Ventilator-associated pneumonia admitted to the adult adult intensive care unit of the Federal University of Uberlândia. The chi-square test was used to compare qualitative variables. Student's t-test was used for quantitative variables and multiple logistic regression analysis to identify independent predictors of mortality. Findings De-escalation of antibiotic therapy and resistant bacteria did not influence mortality. Mortality was 4 times and 3 times higher, respectively, in patients who received an inappropriate antibiotic loading dose and in patients whose antibiotic dose was not adjusted for renal function. Multiple logistic regression analysis revealed the incorrect adjustment for renal function was the only independent factor associated with increased mortality. Conclusion Prescription errors influenced mortality of patients with Ventilator-associated pneumonia, underscoring the challenge of proper Ventilator-associated pneumonia treatment, which requires continuous reevaluation to ensure that clinical response to therapy meets expectations.
Key words
Full text:
1
Index:
LILACS
Main subject:
Drug Prescriptions
/
Drug Resistance, Multiple, Bacterial
/
Pneumonia, Ventilator-Associated
/
Medication Errors
/
Anti-Bacterial Agents
Type of study:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Qualitative_research
/
Risk_factors_studies
Limits:
Adult
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Aged
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Female
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Humans
/
Male
Country/Region as subject:
America do sul
/
Brasil
Language:
En
Journal:
Braz. j. infect. dis
Journal subject:
DOENCAS TRANSMISSIVEIS
Year:
2016
Type:
Article