Background and Objective: Early antibiotic administration is a cornerstone of infection control and treatment. Empirical treatment based on clinical signs and available guidelines reduces mortality and accelerates recovery; however, a lack of information about bacterial species and antibiotic susceptibility may lead to unfavorable outcomes. This study aimed to assess the concordance of empirical antibiotic therapy with definitive prescriptions and antibiogram results.
Methods: This descriptive study included 152 hospitalized patients receiving antibiotics (80 men and 72 women; mean age, 54.41±20.91 years), enrolled by census sampling from the infectious diseases and surgical wards of Shahid Sayyad Shirazi Teaching Hospital in Gorgan, Iran during 2021. Demographic characteristics and data on the initial diagnosis, empirical antibiotic type, microbial culture and antibiogram results, definitive treatment, and treatment duration were extracted from patient records and evaluated.
Results: The most common clinical manifestations were fever (77%) and weakness and fatigue (39%), while the leading reasons for hospitalization were sepsis (31.58%) and urinary tract infection (25.66%). Blood (45.39%) and urine (32.24%) were the most frequently cultured clinical specimens. Escherichia coli (38.8%) and Staphylococcus epidermidis (23.7%) were the most commonly isolated bacteria. Empirical antibiotics were prescribed on 454 occasions, but antibiograms were performed in only one-quarter of cases. The commonly used antibiotics for which antibiograms were performed included ciprofloxacin (14.5%), clindamycin (42%), and ceftriaxone (66.2%). Amikacin (68.4%), ceftriaxone (64.5%), and gentamicin (56.6%) were the antibiotics most frequently included in antibiogram testing. Empirical and definitive therapy were concordant in 75% of cases. The most frequently prescribed antibiotics in definitive therapy were ciprofloxacin (14.04%), clindamycin (13.2%), and ceftriaxone (12.9%). The highest concordance rates in definitive therapy were observed for doxycycline (90%), Tavanex (89.4%), and ciprofloxacin (87.3%), whereas gentamicin (83.3%) and ceftriaxone (40.2%) showed the highest discordance rates.
Conclusion: Empirical antibiotic prescriptions were concordant with definitive prescriptions in most patients. Nevertheless, the antibiotics included in antibiogram testing were not fully aligned with those prescribed in clinical practice.