Accuracy of Antibiotics Used in Sepsis Patient in the Emergency Department

Abstract

Objective: The purpose of this study to determined that antibiotic selection by emergency physicians can cover pathogen organisms in severe sepsis and septic shock patients. Moreover, the effect of pathogen-coverage antibiotics on mortality and length of stay of the patients.

Methods:  

A retrospective review, data of patients who diagnosed with severe sepsis, and septic shock in the emergency department of Maharaj Nakorn Chiangmai hospital, from June 2011 to May 2012. Data on antibiotics by emergency physician decision and culture result was recorded.

Result: 85 patients were eligible in this study. 21 severe sepsis patients and 64 septic shock patients who received coverage antibiotics 80.9% and 82.9% respectively. In severe sepsis, the mortality of antibiotic coverage group was less than the un-coverage antibiotic group (20 % vs. 25 %, respectively; p = 0.048). Also, in septic shock, mortality of coverage antibiotic group was less (28.3% vs. 30.0%; p = 0.012 ). Length of stay of the patients who receive coverage and un-coverage antibiotic in severe sepsis group was no difference (14.5 % and 14.3 % respectively; p = 0.974) Besides, in septic shock, Length of stay of the patients was no difference in both groups (18.2 % and 11.1 %; and p = 0.287)

Conclusion: Patients with severe sepsis or septic shock who arrived in the emergency department receive the appropriate antibiotic selected by the emergency physicians. Moreover, an appropriate antibiotic can reduce in mortality.