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Submitted: 05 February 2014 Modified: 13 June 2014
HERDIN Record #: R04A-DLSHSI-14020509061293

Comparison of Outcome Between Adherence and Non-Adherence to ATS Antibiotic Guideline Among Patients with Ventilator Associated Pneumonia: A Hospital-Based retrospective Study

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Abstract

Background: The American Thoracic Society guideline was established for use in the initial management of patients in whom Ventilator Associated Pneumonia is suspected. This study was undertaken to determine the impact of the guidelines in the management of ventilator associated pneumonia on the outcome of patients at De La Salle University Medical Center (DLSUMC).

Objective: To determine association of adherence to ATS guideline with clinical outcome among patient with VAP at DLSUMC.

Methods: This is a retrospective study. Data of patient with ventilator associated pneumonia were collected from medical records. All patients were divided into 2 groups (adherent and non-adherent) based on compliance with the treatment recommendations of the ATS guidelines. The outcome measures include length of hospital stay, length of mechanical ventilation, and in-hospital mortality. These variables were compared between the adherent and non adherent groups.

Results: There were 298 patients included with age ranging from 19 to 93 years (138 male and 160 female). Of which, 112 patients were adherent with ATS guidelines (37.58%). The patient who was adherent with ATS guidelines had almost two-fold lower mortality than those who are non- adherent (30.36% vs 54.84%; RR 0.54; 95%CI 0.41-0.75; p<0.0001), and shorter hospital stay (28.91 vs 33.19, p=0.0238) and length of time after VAP (9.34 vs 9.96, p=0.0456). However, no significant differences in terms of length of mechanical ventilation and length of ICU stay were observed.

Conclusion : Adherence with ATS guidelines improves the survival of patients, however with longer length of hospital stay; these were not significantly different with non-adherence in terms of length of mechanical ventilation, and length of ICU stay.
There were independent predictors of mortality such as gender, cardiac co-morbid conditions, and neoplasm. Late onset VAP is more common than early onset VAP

Objectives

Objective: To determine association of adherence to ATS guideline with clinical outcome among patient with VAP at DLSUMC.

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3/F Room 6301 De La Salle Angelo King Medical Research Center Abstract Print Format

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