Knowledge about antibiotic utilization and resistance patterns of most common microorganisms are unavailable in tertiary care hospitals. To assess the pattern of antibiotic utilization and outcome of patients in a General Medical Ward, all positive blood cultures (BC) over a 4 month period from July 2019 to October 2019 were retrospectively reviewed. Sixty-five positive BC were recorded in which patients (43% males & 22% females). 72% of the patients received antibiotics before or soon after obtaining the BC, and ceftriaxone was the most frequently-prescribed antibiotic (41.93%), either alone or in combination with other antibiotics. The bacteraemia was due to gram-positive cocci in 60.46% of cases, gram-negative rods in 30.23%, and gram-positive rods in 9.30%. Positive BC due to contamination was not included. The most common gram-positive cocci were Staphylococcus epidermidis, followed by S. aureus, while the most common gram-negative bacilli were Brucella species, Proteus mirabilis, and Klebsiella sp. The suspected sources of the bacteraemia were respiratory (21.2%), urinary (19.2%), or skin (19.2%). A subsequent change in the antibiotics regimen was done in 69.76% cases after BC results became available with no apparent effect on the outcome. Adding Cefotaxime, Amoxicillin clavulonic acid, piperacillintazobactum, vancomycin and clindamycin was the most frequent change done (19.4% for each equally). Complications developed in 69.76% of patients, with 88.66% of them suffering from sepsis/shock. 69.23% of the patients improved and 30.77% expired; death was related to infection in 87.5% of cases. In conclusion, most bacteremia in the medical ward of the hospital were due to gram-positive cocci, which should be considered in antibiotic selection prior to BC.
Antibiotic, resistance, sensitivity, blood culture, medical, utilization
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