Evaluation of mortality rate among patients submitted to a guideline for treatment of nosocomial pneumonia in the Intensive Care Unit of the Regional University Hospital, Londrina, Paraná, Brazil
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KeywordsIntensive Care Unit Vancomycin Levofloxacin Bronchoalveolar Lavage Imipenem
Nosocomial pneumonia is an important health problem that still generates great controversy and is the most common intensive care unit (ICU)-acquired infection with high mortality rate.
To determine the incidence and mortality rates among inhospital-developed pneumonia patients in an ICU with 10 beds of a university hospital, a 614 patient prospective sequential analysis was performed from the period of June 2002 to January 2003. All patients had been treated in accordance with a guideline developed by the hospital's Infection Control Commission. For pneumonia diagnosis, the clinical criteria used by the Center for Diseases Control were adopted. For technical reasons, only 14 (8.4%) patients were submitted to bronchoalveolar lavage.
Among the 614 patients admitted to the ICU during that period of time, 60 (11%) developed nosocomial pneumonia and 55 (95%) had been submitted to mechanical ventilation support. The antimicrobial drugs utilized for treatment of these patients (defined in means of DDD by 1000 beds by day), were: cefepime, 4933.33; piperacillin/tazobactam, 3750.00; ciprofloxacin, 466.67; vancomycin, 8283.33; teicoplamin, 366.67; meropenen, 9066.67; imipenem, 950.00; and levofloxacin, 1666.67. Twenty-eight (46%) patients evolved to death.
In this present study, incidence and mortality rates did not differ from literature data, despite appropriate and early treatment of these infections.