Related Experiment Video
Updated: Jun 4, 2025
Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Efficacy of quality improvement interventions on antibiotic prescription practices for ventilator-associated
Vijay Kumar1, Ratnadeep Biswas2, Vishnu Shankar Ojha1
1Department of General Medicine, All India Institute of Medical Sciences, Patna, Bihar, India.
Background:
Ventilator-associated pneumonia (VAP) is a prevalent nosocomial infection in the intensive care unit (ICU), significantly increasing patient morbidity, mortality, and healthcare costs. Effective management is essential, particularly in the context of antimicrobial resistance and the frequent use of antibiotics in ICUs.
Methods:
This prospective pre-post interventional study was conducted in the medical ICU of a tertiary care centre, over 6 months. Adult patients diagnosed with VAP and receiving antibiotics for more than 48 hours were included. The study involved three phases: preintervention (baseline antibiotic prescription audit), intervention (educational sessions, multidisciplinary meetings and tailored feedback) and postintervention (follow-up audit). Data analysis included Kaplan-Meier survival curves and statistical comparisons of ICU stay durations.
Results:
In the preintervention phase, the median treatment duration was 24 days, while the postintervention phase reduced this to 17 days. Kaplan-Meier curves showed improved survival probabilities and shorter ICU stays in the postintervention phase. The mean ICU stay decreased significantly from 24 days preintervention to 11.3 days postintervention (p=0.027). Mortality rates also improved, with 38.5% discharged and 61.5% deaths postintervention, compared with 23.5% discharged and 76.5% deaths preintervention. Antibiotic prescription patterns shifted towards more targeted therapy, adhering better to culture and sensitivity results and reducing the use of broad-spectrum antibiotics and polypharmacy.
Conclusion:
Quality improvement interventions significantly improved VAP management by reducing treatment duration, ICU stay and mortality rates. Educational sessions, multidisciplinary collaboration and tailored feedback enhanced antibiotic prescription practices, highlighting the importance of continuous quality improvement in ICU settings. Further research and sustained efforts in antimicrobial stewardship are essential to combat VAP and improve patient outcomes.
More Related Videos
09:26Antibiotic Efficacy Testing in an Ex vivo Model of Pseudomonas aeruginosa and Staphylococcus aureus Biofilms in the Cystic Fibrosis Lung
Published on: January 22, 2021
07:46Use of Artificial Sputum Medium to Test Antibiotic Efficacy Against Pseudomonas aeruginosa in Conditions More Relevant to the Cystic Fibrosis Lung
Published on: June 5, 2012
Related Concept Videos
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:28Antimicrobial Effectiveness
01:30Pneumonia III: Complications and Assessment
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...