Clinical Outcomes of Antibiotic Therapy in the Management of Infections Caused by Gram-Positive and Gram-Negative Organisms in a Tertiary Care Hospital

Background

Infections caused by Gram-Positive and Gram-Negative bacteria are still a major cause of morbidity, mortality and prolonged hospital stay. The differences that are present in the cell wall structure play a major role in antibiotic susceptibility and the clinical outcomes, since Gram-negative infections are usually associated with higher rates of multidrug resistance and septic shock. This study evaluates the clinical and laboratory outcomes to antibiotic therapy in such infections at a tertiary care hospital.

Materials and Methods

This prospective observational study was performed using antibiogram to find susceptibility and resistance for Gram-Positive and Gram-Negative bacteria. Biomarkers such as CRP, procalcitonin and hematological parameters were used to analyse the clinical outcomes of the antibiotics.

Results

Of the 105 patients enrolled, most were male (67.6%) and nearly half were elderly (45.7%). Gram-negative organisms dominated the culture reports (78%) with Klebsiella and E. coli being the majority at 40% and 38%. Meropenem (25.4%) and piperacillin+tazobactam (20.9%) were the most commonly prescribed antibiotics. The most resistant drugs were cefuroxime (65.5%), ampicillin (62.1%) and ciprofloxacin (60.3%). A Student's t-test was performed, and PCT (p=0.02) significantly decreased in Gram-Positive infections, while CRP (p=0.01) improved markedly in Gram-Negative infections. Overall survival rates were 88.4% and 89.5% for Gram-positive and Gram-negative infections, respectively.

Conclusion

This study highlights the challenges of growing resistance to commonly used antibiotics, caused by Gram-Positive and Gram-Negative organisms. It also shows the need for antimicrobial stewardship to improve patient care and outcomes.