Correlation between the Suitability of Empirical Antibiotic Therapy and Culture Results on Clinical Outcomes of Pneumonia Patients at Dr. Soetomo Regional Public Hospital, Surabaya

Pneumonia is a global health concern, causing significant morbidity and mortality, particularly among vulnerable populations. This study, conducted at Dr. Soetomo Regional Public Hospital (RSUD Dr. Soetomo), Surabaya, Indonesia, aimed to assess the causative pathogens, antibiotic sensitivity patterns, and the impact of empiric therapy on the clinical outcomes of pneumonia patients. The present study analyzed 324 cases from January to March 2023, categorizing pneumonia as community-acquired (CAP), hospital-acquired (HAP), and ventilator-associated (VAP). Gram-negative bacteria, predominantly Klebsiella pneumoniae, were the primary pathogens, with 44% being multidrug-resistant. Antibiotic sensitivity patterns highlighted the efficacy of amikacin, cefoperazone sulbactam, and meropenem against Gram-negative bacteria. Empiric therapy, mainly monotherapy, showed varied outcomes across pneumonia types. Clinical improvement was observed in 72.5% of CAP patients, while HAP and VAP patients faced challenges, with high mortality rates of 47.2% and 89.1%, respectively. Clinical stability in CAP correlated with age, culture results, multidrug resistance, pneumonia severity, and antibiotic class. In HAP, appropriate empiric therapy and pneumonia severity influenced clinical outcomes. Notably, VAP patients experienced poor outcomes irrespective of the variables studied. This study underscores the importance of local pathogen prevalence awareness and tailored empiric therapy to enhance pneumonia management, especially in HAP and VAP cases. Further research is warranted to refine treatment strategies and improve patient outcomes.