A retrospective evaluation of antimicrobial management among patients with sepsis in Intensive Care Unit (ICU) at Gaborone Private Hospital in Botswana

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Date
2024
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Publisher
University of Namibia
Abstract
Sepsis, a life-threatening response to infection, demands swift and precise antimicrobial intervention. Even though antimicrobial guidelines crafted in high-income countries are employed in low-income settings, these regions encounter unique challenges, including differences in pathogen ecology, high HIV co-infection rates, prevalent comorbidities, and frequent antimicrobial shortages. Such challenges can lead to deviations from standard guidelines, impacting sepsis management and potentially influencing mortality rates. This research adopted a quantitative cross-sectional approach aimed to scrutinize the appropriateness of antimicrobial treatment for sepsis and to determine the susceptibility patterns of prevalent pathogens among sepsis patients in an ICU at a private hospital in Gaborone. A time period prior to COVID-19 was selected to avoid the effects of the pandemic on prescribing. This study used a total population sample of 132, where all patients meeting the inclusion criteria in the selected data range were included. Results show central nervous system infections are the most prevalent infectious source, constituting 20.5% of cases. Notably, even though a substantial proportion of empirical antibiotic treatments are confined to standard guidelines, utilization of local guidelines was associated with an increased odds of death, which requires further study and evaluation. (OR 3.68, CI 1.28-10.6, p=0.012), The study underscores the importance of regularly updating guidelines to reflect current practices, ensuring optimized sepsis management
Description
A mini thesis submitted in partial fulfilment of the requirements for the degree of Master of Pharmacy (clinical pharmacy)
Keywords
Sepsis, Antimicrobial Stewardship, Antibiotic resistance, Low- and Middle-Income Countries, Empirical Antibiotics, Botswana, ICU, Patient Outcomes, University of Namibia
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