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The Status of Resistance to Empirical Antibiotics Among Pathogens Causing Hospital-Acquired Pneumonia in Busan, Korea
J. Kor. Soc. Health-syst. Pharm. 2018;35:48-58
Published online February 28, 2018
© 2018 Korean Society of Health-System Pharmacists

Da Hyun Oha, Yoonsook Kima, and Pusoon Chunb,†

Division of Pharmacy, Inje University Haeundae Paik Hospital, Haeundae-ro 875, Haeundae-gu, Busan 48108, Republic of Koreaa College of Pharmacy, Inje University, 197 Inje-ro, Gimhae, Gyeongnam 50834, Republic of Koreab
Correspondence to: 천부순 Tel:055-320-3886 E-mail:pusoon@inje.ac.kr
Received July 8, 2017; Revised August 18, 2017; Accepted December 28, 2017.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background : Although the prevalence of antibiotic resistance may vary according to region, there is no guidance developed in Korea on the use of empirical antibiotics for the treatment of hospital-acquired pneumonia (HAP). The purpose of this study was to investigate the patterns of empiric antibiotic therapy and resistance of the isolated pathogens to the empirical antibiotics in the management of HAP in Korea.
Methods : A retrospective analysis was conducted using the electronic medical records of the HAP patients January 2014-December 2015 in Korea. The patterns of prescribing empirical antibiotics and resistance of the isolated pathogens to the empirical antibiotics were examined.
Results : A total of 170 patients was analyzed. Piperacillin/tazobactam was the key agent in the empirical antibiotics. The most common pathogen was Staphylococcus aureus (27.9%) followed by Acinetobacter baumannii (21.6%), Klebsiella pneumoniae (11.1%), Pseudomonas aeruginosa (6.3%), Stenotrophomonas maltophilia (5.8%), Enterobacter aerogenes (5.3%), and Escherichia coli (5.3%). The resistance rates of S. aureus to ciprofloxacin was 76%. E. coli had high level of resistance rate to ciprofloxacin (80%) and low resistance rate to imipenem (10%). K. pneumoniae and P. aeruginosa showed very high level of sensitivity to imipenem (100%) and cefepime (91.7%), respectively. To piperacillin/tazobactam, E. coli, E. erogenes, K. pneumoniae, and P. aeruginosa showed high level of sensitivity (52.4-100%). A. baumannii exhibited high-level resistance rates (63.4-85.4%) to the empirical antibiotics, including cefepime, ceftazidime, ciprofloxacin, imipenem, and piperacillin/tazobactam.
Conclusion : The empirical antibiotic therapy was appropriate for the initial treatment of HAP owing to the adequate antibiotic coverage. Piperacillin/tazobactam was used in most patients and the most common pathogens including Pseudomonas aeruginosa had high level of sensitivity to the drug. The high level of resistance of A. baumannii to the empirical antibiotics is one of the major challenges in treating HAP.
Keywords : Antibiotic resistance, Empirical antibiotics, Hospital-acquired pneumonia


February 2018, 35 (1)