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Abstract
EVALUATING THE RESPONSE TO COMBINATION THERAPY WITH NEBULIZED AMIKACIN, IV AMIKACIN AND MEROPENEM IN PATIENTS WITH VENTILATOR-ACQUIRED-PNEUMONIA WITH RESISTANT SERRATIA TRACHEAL CULTURES IN ICU OF VALI-E-ASR HOSPITAL IN ZANJAN
Mehdi Azimi, Dr. Seyede Sahar Babaali* and Amirhossein Moghtader Mojdehi
ABSTRACT
Background: There have been reports of increased rates of multi-drug resistant VAP in the ICU of Zanjan Vali-e-Asr hospital. Suggesting an appropriate therapeutic regimen is of paramount importance, which is the main goal of this study. Method: This non-randomized uncontrolled semi experimental study was carried out with a total number of 45 patients who were selected from ICU of Zanjan Vali-e-Asr hospital. All patients were diagnosed with Serattia-positive multi-drug resistant VAP and treated with the suggested therapeutic regimen. The effectiveness of the regimen was evaluated through the CPIS before and after the treatment. Thereafter, the results were analyzed by SPSS and STATA software. Results: Our data indicate significant changes in body temperature with p value=0.004 (from 37.4±0.6 on the 1st day to 37±0.3 on the 15th day), pulse rate with p value=0.003(from 90.8±16.1 on the 1st day to 83.7±9.1 on the 15th day), systolic blood pressure with p value=0.009 (from 108.8±10.5 on the 1st day to 107.1±8.8 on the 15th day) and creatinine level with p value=0.005(from 1.4±1.3 on the 1st day to 1±0.6 on the 15th day). Although not statistically significant, radiologic changes and the pulmonary secretion both followed an overall improving pattern. The total cure rates on day 7 and day 15 were not statistically significant. Conclusion: Our study reports a positive response to our recommended therapeutic regimen in patients with VAP. Our findings also indicate that the antibiotic preference is not dependent on early or late VAP; especially in complicated cases such as patients admitted to ICU. We highly recommend a similar study conducted with the control group.
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