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Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 2016 (2016), Article ID 3702625, 10 pages
http://dx.doi.org/10.1155/2016/3702625
Research Article

Antibiotic Utilization Patterns in Patients with Ventilator-Associated Pneumonia: A Canadian Context

1Department of Pharmacy Services, Alberta Health Services-Calgary Zone, Calgary, AB, Canada
2Critical Care, Department of Pharmacy Services, Alberta Health Services-Calgary Zone, Calgary, AB, Canada
3Pediatrics, Department of Pharmacy Services, Alberta Health Services-Calgary Zone, Calgary, AB, Canada
4Departments of Critical Care Medicine and Medicine, Cumming School of Medicine, University of Calgary, Peter Lougheed Centre, Alberta Health Services-Calgary Zone, Calgary, AB, Canada

Received 11 June 2015; Accepted 13 November 2015

Copyright © 2016 Tracy Chin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This retrospective cohort study describes the patterns of antibiotic use for the treatment of ventilator-associated pneumonia (VAP) in the Calgary Zone of Alberta Health Services. Timing, appropriateness, and duration of antibiotics were evaluated in two hundred consecutive cases of VAP derived from 4 adult intensive care units (ICU). Antibiotic therapy was initiated in less than 24 hours from VAP diagnosis in 83% of cases. Although most patients (89%) received empiric therapy that demonstrated in vitro sensitivity to the identified pathogens, only 24% of cases were congruent with the 2008 Association of Medical Microbiology and Infectious Disease (AMMI) guidelines. Both ICU () and hospital () mortality were significantly lower and there was a trend for shorter ICU length of stay () in patients who received appropriate versus inappropriate initial antibiotics. There were no outcome differences related to compliance with AMMI guidelines. This exploratory study provides insight into the use of antimicrobials for the treatment of VAP in a large Canadian health region. The discordance between the assessments of appropriateness of empiric therapy based on recovered pathogens versus AMMI guidelines is notable, emphasizing the importance of using as much as possible local microbiologic and antimicrobial resistance data.