%0 Journal Article
%T Sputum Bacteriology And In-Vitro Antibiotic Susceptibility In Hospitalized Patients With Community Acquired Pneumonia In A State Tertiary - Referral Hospital ¨C A Retrospective Study
%A Yow-Wen Chin
%A Li-Cher Loh
%A Thim-Fatt Wong
%A Abdul Razak Muttalif
%J International e-Journal of Science, Medicine & Education
%D 2007
%I International Medical University, Malaysia
%X Introduction: To review the sputum bacteriology and itsin-vitro antibiotic susceptibility in patients hospitalizedwith community-acquired pneumonia (CAP) in a statetertiary-referral Hospital (Penang hospital, Malaysia) inorder to determine the most appropriate empiricantibiotics.Methods: From September 2006 to May 2007,68 immunocompetent adult patients [mean age: 52years (range 16-89); 69% male] admitted to respiratorywards for CAP with positive sputum isolates within 48hours of admission were retrospectively identified andreviewed.Results: 62 isolates were Gram(-) bacilli (91%) &6 were Gram(+) cocci (9%). The two commonestpathogens isolated were Pseudomonas aeruginosa(n=20) and Klebsiella pneumoniae (n=19)together constituted 57% of all positive isolates.Among the Pseudomonas isolates, 84.2% were fullysensitive to cefoperazone and cefoperazon/sulbactam;95% to ceftazidime, cefepime, piperacillin/tazobactam,ciprofloxacin and amikacin, and 100% to gentamycin,netilmycin, imipenem and meropenem. Among theKlebsiella isolates, 5.3% were fully sensitive toampicillin; 84.2% to amoxicillin, ampicllin/sulbactam,cefuroxime and ceftriazone; 89.5% to piperacillin/tazobactam; 93.3% to cefoperazon/sulbactam and 100%sensitive to ceftazidime, cefepime, ciprofloxacin,all aminoglycosides and carbopenems.Conclusion: In view of the high prevalence ofrespiratory Pseudomonas aeruginosa, ampicillin/sulbactam, currently the most prescribed antibiotic totreat CAP in our respiratory wards, may not be the mostappropriate empiric choice. Higher generationcephalosporins with or without beta-lactamaseinhibitors, ciprofloxacin or carbapenem may be themore appropriate choices. The lack of information onpatients¡¯ premorbidities such as recent hospitalizationand prior antibiotic exposure, limits the interpretationof our findings and may have biased our results towardshigher rates of Gram negative organisms.
%K Antibiotic sensitivity
%K Community-acquired pneumonia
%K Penang hospital
%K Sputum bacteriology
%U http://web.imu.edu.my/ejournal/approved/eJournal_1.2_74-79.pdf