Empirical use of antibiotics in Emergency Department of Tribhuvan University Teaching Hospital and Treatment Success Rate in Discharged Patients

Abstract

Introduction: Infectious diseases are the common presentation in emergency department, which require treatment within minutes. As a result, the empirical antibiotics are started prompt in emergency department before the bacteriological results are available. Therefore, the aim of this study was to explore the use of antibiotics at emergency room and to determine the success rate in discharged patients.

Methods: A descriptive, exploratory, non-interventional study was conducted during 8 weeks among the discharged patients from emergency department who received the antibiotic therapy and culture/ sensitivity test was asked. Patients were followed from emergency room and adequate information was taken from emergency records and also at the time of outpatient department visit.

Results: Out of 297 patients, only 179 patients were studied. We found that 75.1% of empirically prescribed antibiotics were oral. The most commonly administered intravenous and oral antibiotics were ceftriaxone (20.4%) and cefixime (17.0%). The most common isolate leading to emergency department visit was Escherichia coli (29 patients, 16.2%). In vitro sensitive test for gram positive and gram negative isolates, amoxicillin-clavulanate combination and ciprofloxacin were most effective and cefixime was the least effective antibiotic. The treatment success rate was found to be 147(82.1%) of the patients, as the medication prescribed at emergency room was continued by outpatient department physician.

Conclusion: Quinolones and cephalosporins groups of antibiotics are rising as the determinant antibiotics at emergency room. The rate of appropriate use of antibiotics and treatment success rate were found to be higher.