Abstract
Septicemia is a common clinical condition encountered in most of the hospitals in
this region of the world. However, limited information is available in the Indian
literature on antimicrobial usage in patients with suspected or proven cases of septicemia.
The aim of the present study is on the one hand to describe the clinical characteristics
of septicemia, the causative pathogens, the current pattern of antimicrobial use,
the clinical outcome, the acquisition cost of commonly used antimicrobial regimens
and on the other hand to monitor adverse drug reactions (ADRs) during therapy of septicemia
patients admitted to a University Hospital in Delhi. We prospectively reviewed the
antimicrobial therapy in 34 clinically diagnosed septicemia cases admitted to a University
Hospital from July 2009 to December 2009. All study patients presented various clinical
signs and symptoms, fever, diarrhoea and vomiting were most commonly reported. Microorganisms
could be identified in 13 (38.2%) of the patients. Escherichia coli (41.2%) constituted the most prevalent bacterial pathogen. Among culture positive
patients, 15.4% received ceftriaxone as the most common empirical antimicrobial therapy;
among culture negative patients, 19% received cefotaxime plus amikacin as the most
common empirical antimicrobial therapy. The average acquisition cost of the 1st line antimicrobial regimen was higher in culture positive than in culture negative
patients, but it was reversed for the 2nd line therapy. Overall, 67.6% patients were discharged after recovery, 23.5% were
transferred out and 8.8% died during the course of therapy. 9 (26.5%) patients experienced
ADRs during the antimicrobial therapy. These findings may have an important implication
for developing comprehensive, evidence-based guidelines for the practical treatment
of septicemia, adherence to which may lead to a more rational antimicrobial therapy,
to cost reduction and to an improved level of care of patients with septicemia.
Key words
septicemia - antimicrobial therapy - acquisition cost - therapy outcome - adverse
drug reaction
