Evaluation of Severity, Antibiotic Prescribing Patterns, and Outcomes of Sepsis in the ICU Using the APACHE-IV Scale
Abstract
Sepsis, the body’s systemic immune response to infection, can execute organs. This study assessed the prevalence, severity, prescribing pattern of antibiotics, and outcomes of sepsis. This observational-analytical prospective investigation was conducted on 70 ICU patients admitted with severe sepsis and septic shock in health care. The severity of illness was assessed by Acute Physiology and Chronic Health Evaluation IV (APACHE-IV). Antibiotic prescribing trends were also assessed to optimize therapeutic failure risk assessment for septic ICU patients. Fisher's exact test and Pearson-Chi square test were used to determine the statistical relationship between age, APACHE-IV score, therapeutic outcome, and microbial growth studies across different parameters. The clinical and laboratory profiles of the survivor and non-survivor groups were compared using one-way ANOVA. Results showed that sepsis occurred in one quarter (25.1%) of ICU-admitted patients. APACHE-IV has under-predicted death rates as the Actual Mortality Rate (AMR = 50%) is higher than the average APACHE-IV predicted mortality rate (PMR = 36.6%). The use of combination antibiotics is more prevalent in empiric therapy than in definitive therapy. Gram-negative organisms were the most prevalent cause of sepsis in the ICU. Meropenem was the most prescribed empiric antibiotic either as monotherapy or in combination, whereas colistin was the most prescribed antibiotic in definitive therapy either alone or in combination. This study concluded that sepsis is associated with high mortality. Continuous calibration of severity scales can improve patient outcomes. Judicious use of antibiotics is highly recommended as the last resort of antibiotics for treating sepsis. This study focused on optimizing antibiotic stewardship programs to improve treatment options for critically ill septic patients in ICUs. It integrates APACHE IV scoring and provides a comprehensive analysis of antibiotic choices.
Keywords: APACHE score, intensive care unit, antibiotic intervention, SAP, culture sensitivity.
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