Evaluation of Antimicrobial Prescription in Empiric and Definitive Therapy Of Bloodstream Infections due to Salmonella spp. and Salmonella typhi
- Author:
Muhammad Riko Dadiarta
1
;
Osman Sianipar
2
;
Arum Tri Wahyuningsih
2
Author Information
- Publication Type:Journal Article
- Keywords: Antimicrobial resistance, Definitive antimicrobial, Empirical antimicrobial, Salmonella spp., Salmonella typhi.
- From:Malaysian Journal of Medicine and Health Sciences 2020;16(Supp 3,June):43-48
- CountryMalaysia
- Language:English
- Abstract: Introduction: As the main cause of typhoid, Salmonella spp., especially Salmonella typhi contribute to the incidence of community-acquired bloodstream infections in developing countries. Annually, there are around 20 million cases of typhoid fever and more than 150,000 deaths reported. However, several studies suggest Salmonella spp. have become resistant to some antimicrobials. This resistance to antibiotics may be caused by inappropriate antimicrobial prescriptions. Methods: This research was a descriptive observational study. Data of clinical isolates of Salmonella spp. from blood cultures and results of antimicrobial sensitivity tests were obtained from the Clinical Laboratory Installation of Dr. Sardjito General Hospital. The data were then processed and analyzed using descriptive statistics and proportion tests. Results: We obtained 14 isolates of Salmonella spp. and 11 isolates of Salmonella typhi. All of the Salmonella spp. isolates were resistant to cefazolin, but 100% of isolates were sensitive to aztreonam, ceftazidime, ciprofloxacin, etc. All of the Salmonella typhi isolates were resistant to tetracycline and cefazolin, but 100% of isolates were sensitive to aztreonam, ceftazidime, ciprofloxacin, etc. The number of inappropriate definitive antimicrobial prescriptions due to Salmonella spp. and Salmonella typhi infections at Dr. Sardjito General Hospital was 47.36% (p=0.0015;95%CI:0.2846-0.6614). The proportion of cephalosporin used as empiric therapy for bloodstream infection was 68% (95%CI:0.52-0.83). Conclusions: Significant number of inappropriate antimicrobial prescriptions in definitive treatment of bloodstream infections caused by Salmonella typhi and Salmonella spp. were found at Dr. Sardjito General Hospital in 2018. More efforts are needed to properly prescribe antimicrobials and prevent increases in antibiotic resistance microbes.
- Full text:11.2020my0717.pdf
