The use of empirical antibiotics in intensive care unit and relationship between nutrition and the incidence of infection

Authors : Salih YILDIRIM, Yavuz ORAK, Rukiye MENEMENCİOĞLU, Ahmet ALTUN, Filiz ORAK, Cevdet DÜGER, Esra ÖZPAY, Fatih Mehmet YAZAR

Pages : 489-498

Doi:10.5798/dicletip.620514

View : 29 | Download : 20

Publication Date : 2019-09-16

Article Type : Research Paper

Abstract :Objective: Aim of study is to determine which antibiotic is started empirically in the ICU and to investigate whether the antibiotic started according to culture result was changed or not and the effect of this change on mortality, and to investigate the relationship between mortality and infection by determining whether enteral and parenterally fed patients have attained sufficient calorie level. Method: After the approval of the local ethics committee, the files of 476 patients hospitalized in our hospital were retrospectively reviewed. A total of 159 patients over 18 years of age who received mechanical ventilation therapy for at least 3 days were included in the study. Blood, urine and tracheal aspirate culture were determined. It was recorded whether antibiotics had changed according to the culture result. Nutritional patterns, number of feeding days and basal caloric need were determined. It was investigated whether basal calorie need was met on 1, 3 and 5 days. Factors affecting mortality were investigated. Results: Antibiotic exchange was significantly higher in the patients who died (P = 0.002). Mortality was higher in patients who were unable to reach the target calorie (P = 0.01). Empirical changes in antibiotics (r: 0.174, P = 0.028), and culture positivity (r: 0.177, P = 0.026) were associated with mortality (r: 0.195, P = 0.014). In the subgroup analysis, reproduction in tracheal aspirate culture was an important factor affecting mortality (r: 0.211 P: 0.008). Conclusions: The number of days of hospitalization, antibiotic change, culture positivity and inability to reach the target calories in nutrition are associated with mortality in the intensive care unit.
Keywords : empirical antibiotic therapy, mortality, intensive care unit