Study of antibiotic resistance in patients of enteric perforation in a tertiary care hospital.

Abstract

Objective: To study the clinical outcomes and determine the antibiotic resistance in patients of enteric perforation in a tertiary care hospital. Study Design: Cross Sectional study. Setting: Department of General Surgery at Nishtar Hospital, Multan. Period: May 2017 to December 2019. Material & Methods: Sample size was calculated to be 97 with a confidence level of 95% and margin of error of 10%. We collected data from 100 patients. All the surgeries were done by the same team of consultant surgeons. The abdomen was closed by the same surgical team using the same surgical technique to avoid any bias. All the continuous variables were reported as mean ± standard deviation. The antibiotic resistance was compared with the number of patients with wound infections, burst abdomen, ICU admissions and number of in-hospital stay days. Categorical variables were compared using Chi square test for Independence. The number of in-hospital stay days were compared using Student t-test. The results were compiled using SPSS version 20. Results: Our result indicated that a patient had a greater chance of having a burst abdomen and wound infection if there was resistance to ciprofloxacin or ceftriaxone. Similar results were obtained for ICU admissions. There was a significantly longer in-hospital stay observed for patients who were resistant to the standard regimen of Ceftriaxone. Conclusion: It seems only rationale that the patients susceptible should be treated with Imipinem for 2 weeks as the empirical therapy rather than the standard empirical therapy of ceftriaxone and ciprofloxacin. The blood cultures can be sent before starting Imipinem and treatment management plan changed if the culture results are sensitive for the empiric antibiotics.