A comparison between conventional and stratified antibiograms for antibiotic empirical therapy among the most bacterial pathogens

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Wichai Santimaleeworagun
Wandee Samret
Praewdow Preechachuawong
Mattana Sunpurksin
Sarinrat Tobarameekul
Supakit Hussanunt


Antibiograms provide important data regarding antimicrobial selection during empirical therapy and for monitoring yearly trends in antimicrobial resistance in healthcare settings. Antibiograms tailored to hospital location or specimen type are called stratified antibiograms. This retrospective study compared conventional and stratified antibiograms for Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa at the Hua-Hin hospital between January 2015 and December 2015. Stratified antibiograms were specific to the specimen type or ward were constructed after eliminating duplicate samples. Susceptibilities of 2,323 bacterial isolates of E. coli, S. aureus, K. pneumoniae, A. baumannii, and P. aeruginosa (32.6%, 15.6%, 15.4%, 16.0%, and 20.4%, respectively) were analyzed and percentage antimicrobial susceptibility did not differ between the stratified antibiogram for the first specimen alone and the conventional antibiogram. Similarly, percentage susceptibility between intensive care unit (ICU) and non-ICU wards or specimen type was comparable between the antibiograms. However, percentage susceptibilities of urinary P. aeruginosa isolates to amikacin, gentamicin, and ciprofloxacin were 60.6, 59.2, and 57.7, respectively, which was lower than that seen in the conventional antibiogram, namely, 84.1% (amikacin), 83.5% (gentamicin), and 80.1% (ciprofloxacin). Thus, stratified antibiograms, categorized by specimen type or ward, may be more useful in selecting appropriate empirical therapy.


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