Evaluation of mortality rate among patients submitted to a guideline for treatment of nosocomial pneumonia in the Intensive Care Unit of the Regional University Hospital, Londrina, Paraná, Brazil

Background

Nosocomial pneumonia is an important health problem that still generates great controversy and is the most common intensive care unit (ICU)-acquired infection with high mortality rate.

Methods

To determine the incidence and mortality rates among inhospital-developed pneumonia patients in an ICU with 10 beds of a university hospital, a 614 patient prospective sequential analysis was performed from the period of June 2002 to January 2003. All patients had been treated in accordance with a guideline developed by the hospital's Infection Control Commission. For pneumonia diagnosis, the clinical criteria used by the Center for Diseases Control were adopted. For technical reasons, only 14 (8.4%) patients were submitted to bronchoalveolar lavage.

Results

Among the 614 patients admitted to the ICU during that period of time, 60 (11%) developed nosocomial pneumonia and 55 (95%) had been submitted to mechanical ventilation support. The antimicrobial drugs utilized for treatment of these patients (defined in means of DDD by 1000 beds by day), were: cefepime, 4933.33; piperacillin/tazobactam, 3750.00; ciprofloxacin, 466.67; vancomycin, 8283.33; teicoplamin, 366.67; meropenen, 9066.67; imipenem, 950.00; and levofloxacin, 1666.67. Twenty-eight (46%) patients evolved to death.

Discussion

In this present study, incidence and mortality rates did not differ from literature data, despite appropriate and early treatment of these infections.