Treatment of ventilator-associated pneumonia and ventilator-associated tracheobronchitis in the intensive care unit: A national survey of clinicians and pharmacists in Saudi Arabia

Authors

• Awad Al-Omari, From the Critical Care and Infectious Disease Department (Al-Omari), Critical Care Department (Belal, Al-Subai,), Security Forces Hospital, Critical Care Department (Mohammed), Dr. Sulaiman Al-Habib Group of Hospitals, the Critical Care Medicine Section (Al-Dorzi), King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, the Department of Critical Care Medicine (Albshabshe), King Khalid University, the Intensive Care Department (Arabi), King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, and the Department of Medicine (Alhazzani), Division of Critical Care, McMaster University, Hamilton, Canada
• Masood Mohammed, From the Critical Care and Infectious Disease Department (Al-Omari), Critical Care Department (Belal, Al-Subai,), Security Forces Hospital, Critical Care Department (Mohammed), Dr. Sulaiman Al-Habib Group of Hospitals, the Critical Care Medicine Section (Al-Dorzi), King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, the Department of Critical Care Medicine (Albshabshe), King Khalid University, the Intensive Care Department (Arabi), King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, and the Department of Medicine (Alhazzani), Division of Critical Care, McMaster University, Hamilton, Canada
• Waleed Alhazzani, From the Critical Care and Infectious Disease Department (Al-Omari), Critical Care Department (Belal, Al-Subai,), Security Forces Hospital, Critical Care Department (Mohammed), Dr. Sulaiman Al-Habib Group of Hospitals, the Critical Care Medicine Section (Al-Dorzi), King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, the Department of Critical Care Medicine (Albshabshe), King Khalid University, the Intensive Care Department (Arabi), King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, and the Department of Medicine (Alhazzani), Division of Critical Care, McMaster University, Hamilton, Canada
• Hasan M. Al-Dorzi, From the Critical Care and Infectious Disease Department (Al-Omari), Critical Care Department (Belal, Al-Subai,), Security Forces Hospital, Critical Care Department (Mohammed), Dr. Sulaiman Al-Habib Group of Hospitals, the Critical Care Medicine Section (Al-Dorzi), King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, the Department of Critical Care Medicine (Albshabshe), King Khalid University, the Intensive Care Department (Arabi), King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, and the Department of Medicine (Alhazzani), Division of Critical Care, McMaster University, Hamilton, Canada
• Mohammed S. Belal, From the Critical Care and Infectious Disease Department (Al-Omari), Critical Care Department (Belal, Al-Subai,), Security Forces Hospital, Critical Care Department (Mohammed), Dr. Sulaiman Al-Habib Group of Hospitals, the Critical Care Medicine Section (Al-Dorzi), King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, the Department of Critical Care Medicine (Albshabshe), King Khalid University, the Intensive Care Department (Arabi), King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, and the Department of Medicine (Alhazzani), Division of Critical Care, McMaster University, Hamilton, Canada
• Ali O. Albshabshe, From the Critical Care and Infectious Disease Department (Al-Omari), Critical Care Department (Belal, Al-Subai,), Security Forces Hospital, Critical Care Department (Mohammed), Dr. Sulaiman Al-Habib Group of Hospitals, the Critical Care Medicine Section (Al-Dorzi), King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, the Department of Critical Care Medicine (Albshabshe), King Khalid University, the Intensive Care Department (Arabi), King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, and the Department of Medicine (Alhazzani), Division of Critical Care, McMaster University, Hamilton, Canada
• Maha F. Al-Subaie, From the Critical Care and Infectious Disease Department (Al-Omari), Critical Care Department (Belal, Al-Subai,), Security Forces Hospital, Critical Care Department (Mohammed), Dr. Sulaiman Al-Habib Group of Hospitals, the Critical Care Medicine Section (Al-Dorzi), King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, the Department of Critical Care Medicine (Albshabshe), King Khalid University, the Intensive Care Department (Arabi), King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, and the Department of Medicine (Alhazzani), Division of Critical Care, McMaster University, Hamilton, Canada
• Yaseen M. Arabi, From the Critical Care and Infectious Disease Department (Al-Omari), Critical Care Department (Belal, Al-Subai,), Security Forces Hospital, Critical Care Department (Mohammed), Dr. Sulaiman Al-Habib Group of Hospitals, the Critical Care Medicine Section (Al-Dorzi), King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, the Department of Critical Care Medicine (Albshabshe), King Khalid University, the Intensive Care Department (Arabi), King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, and the Department of Medicine (Alhazzani), Division of Critical Care, McMaster University, Hamilton, Canada

Abstract

Objectives: To assess current practices of different healthcare providers for treating extensively drug-resistant (XDR) Acinetobacter baumannii (AB) infections in tertiary-care centers in Saudi Arabia. Methods: This cross-sectional study was performed in tertiary-care centers of Saudi Arabia between March and June 2014. A questionnaire consisting of 3 parts (respondent characteristics; case scenarios on ventilator-associated pneumonia [VAP] and tracheobronchitis [VAT], and antibiotic choices in each scenario) was developed and sent electronically to participants in 34 centers across Saudi Arabia. Results: One-hundred and eighty-three respondents completed the survey. Most of the respondents (54.6%) preferred to use colistin-based combination therapy to treat VAP caused by XDR AB, and 62.8% chose to continue treatment for 2 weeks. Most of the participants (80%) chose to treat VAT caused by XDR AB with intravenous antibiotics. A significant percentage of intensive care unit (ICU) fellows (41.3%) and clinical pharmacists (35%) opted for 2 million units (mu) of colistin every 8 hours without a loading dose, whereas 60% of infectious disease consultants, 45.8% of ICU consultants, and 44.4% of infectious disease fellows preferred a 9 mu loading dose followed by 9 mu daily in divided doses. The responses for the scenarios were different among healthcare providers ( p <0.0001). Conclusion: Most of the respondents in our survey preferred to use colistin-based combination therapy and intravenous antibiotics to treat VAP and VAT caused by XDR AB. However, colistin dose and duration varied among the healthcare providers.

Article Type

Research Article

First Page

1453

Last Page

1462

Recommended Citation

Al-Omari, Awad; Mohammed, Masood; Alhazzani, Waleed; Al-Dorzi, Hasan M.; Belal, Mohammed S.; Albshabshe, Ali O.; Al-Subaie, Maha F.; and Arabi, Yaseen M. (2015) "Treatment of ventilator-associated pneumonia and ventilator-associated tracheobronchitis in the intensive care unit: A national survey of clinicians and pharmacists in Saudi Arabia," Saudi Medical Journal: Vol. 36: Iss. 12, Article 10.
DOI: https://doi.org/10.15537/smj.2015.12.12345