title: Empirical antibiotic therapy of sepsis in surgical intensive care unit.
abstract: Retrospective study was conducted in surgical intensive care unit (ICU) in Clinical Hospital Center Zagreb in 2005. The aim of study was to create guidelines for empirical antibiotic therapy of sepsis in ICU for unknown causative agent based on antimicrobial susceptibility of causative bacteria. Thirty-two patients with severe sepsis were included in study and from medical records their clinical and microbiological data were analyzed. Antimicrobial susceptibility of the strains isolated from the blood-culture was tested by disk diffusion method according to CLSI (Clinical Laboratory Standard Institution). We used APACHE II score to predict the severity of illness. Mann-Whitney test and chi2 test were used to test statistical significance difference between results. Acinetobacter baumannii and Pseudomonas aeruginosa were the predominant causative agent. Acinetobacter baumannii was displaying excellent susceptibility to ampicillin+sulbactam and carbapenems, whereas Pseudomonas aeruginosa was showed good susceptibility on ceftazidim and carbapenems. Methicillin-resistant Staphylococcus aureus (MRSA), third predominant causative agent exhibiting good susceptibility to vancomycin and linezolide. The recommended therapy is empirical antibiotic therapy and should cover all important pathogens.
authors.affiliation: Clinical Department for Clinical and Molecular Microbiology, Clinical Hospital Center Zagreb, Kispatićeva 12, 10000 Zagreb, Croatia.
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Mihaljević
authors.forename: Slobodan
authors.initials: S
authors.lastname: Mihaljević
authors.forename: Ivan
authors.initials: I
authors.lastname: Vasilj
authors.forename: Semra
authors.initials: S
authors.lastname: Cavaljuga
authors.forename: Fadila
authors.initials: F
authors.lastname: Serdarević
authors.forename: Ivan
authors.initials: I
authors.lastname: Soldo
mesh_terms: D040981:Acinetobacter baumannii / Q000378:metabolism; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D005260:Female; D013502:General Surgery / Q000379:methods; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008712:Methicillin / Q000494:pharmacology; D008826:Microbial Sensitivity Tests / Q000379:methods*; D008875:Middle Aged; D011550:Pseudomonas aeruginosa / Q000378:metabolism; D018805:Sepsis / Q000188:drug therapy*; D013211:Staphylococcus aureus / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D008712:Methicillin