Evaluation of Empirical Treatment Response in Hospitalized Patient Community Acquired Pneumonia

· Critical Care, Lung Infection

Fikri Faisal, Erlina Burhan, Wahju Aniwidyaningsih, Aria Kekalih

Departemen Pulmonologi dan Ilmu Kedokteran Respirasi, Fakultas Kedokteran Universitas Indonesia, RS Persahabatan Jakarta
Departemen Ilmu Kedokteran Komunitas, Fakultas Kedokteran Universitas Indonesia

Background: Pneumonia is the first leading disease with the highest mortality in hospitalized patients. The purpose of this study are to determine treatment responsse for the empirical treatment of CAP patients and the factors associated with patterns of bacteria, treatment response, clinical symptoms, laboratory and chest X-ray, length of stay and comorbidities in Persahabatan Hospital, Jakarta.
Methods: Prospective cohort study in hospitalized community acquired pneumonia patients were evaluated at Persahabatan Hospital along 15 month. Clinical symptoms, laboratory findings, chest x-ray and microbiologic were evaluated. Microbiologic test conducted before and after antibiotic administration.
Results: There were 47 patients, male 74.5% and female 25.5%. The average age was 61 years old. Clinical symptoms empirical before treatment were dyspnea 51% decreased to 27.7% and cough 32% decreased to 23.4%. Leukocytes count was 15.27 cell/mm3 decreased to 12.0 cell/mm3. Chest x-ray infiltrates 89.3% decreased to 38.3%. Before-treatment microbiological patterns were K. pneumoniae 34.0%. Result after empirical treatment was eradication 91.5%. The most frequent initial antibiotic administration was ceftriaxone. The most frequent comorbidity was thoracic malignancy. The patients were hospitalized at least for 4 days with replacement therapy at least for 3 days.
Conclusion: Patients with CAP predominantly showed symptoms of dyspnea and cough, infiltrates on chest x-ray and Gram-negative Klebsiella pneumonia in sputum samples. There were decrease of leucocyte counts after antibiotic administration. (J Respir Indo. 2014; 34: 60-70)
Keywords: pneumonia, leukocyte, risk factors, microorganism, resistance.

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