Maharani Wahyuning Tyas and Budi Suprapti and Hardiono and Agung Dwi Wahyu Widodo (2013) Analysis of antibiotic use in vap (ventilator-association pneumonia) patients. Folia Medica Indonesiana, 49 (3). pp. 168-172. ISSN 0303-7932

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Abstract

VAP is a nosocomial infection that most often occurs in the ICU. VAP increases morbidity, mortality, treatment costs andhospitalization time in the ICU. Antibiotic is primary therapy in VAP. The initial selection of antibiotic is very important todetermind outcome in VAP patients, as well as a main factor that plays a role in the development of antibiotic resistance. Availabilityof bacterial pattern and bacterial sensitivity pattern is very important to make consideration on empirical antibiotic treatment inVAP patients. The purpose is to identify bacterial pattern, bacterial sensitivity pattern and to analyze antibiotic therapy in VAPpatients. An observational prospective analysis was carried out in the ICU Dr. Soetomo Hospital. Data was collected from Januaryto March 2013. Patients who met the inclusion criteria were observed prospectively. Bacterial pattern and bacterial sensitivitypattern were identified based on the results of culture test and sensitivity test. Quality of antibiotic usage could be assessed withGyssen’s flowchart. From 158 patients with ventilator, nine patients met the inclusion criteria with thirty specimens (13 sputum, 17blood). Pseudomonas aeruginosa was the common bacteria found in the sputum. Blood culture, revealed that Staphylococcuscoagulase-negative was the common bacteria. Antibiotics that are still sensitive against Pseudomonas aeruginosa are Piperacillintazobaktam,Cefoperazon-sulbactam, Meropenem, Tobramycin, Levofloxacin. Pseudomonas aeruginosa is the common cause ofpneumonia in adult patient who used ventilator that susceptible with various antibiotic spectrums.(FMI 2013;49:168-172)

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