AI Article Synopsis
Article Abstract
Background: The increasing occurrence of multidrug resistant (MDR) bacteria arises at a time when there is a lack of antibiotics active against these pathogens and few new antimicrobials are in the pipelines of the pharmaceutical industry. Treatment of ventilator-associated pneumonia (VAP) caused especially by MDR Gram-negative bacilli (GNB) represents a real challenge due to the dearth of treatment options.
Methods: We searched the medical literature relevant about management of ventilator-associated pneumonia caused by multi-drug resistant pathogens including GNB and methicillin-resistant S. aureus.
Results: Empirical therapy should be prescribed based on the local pattern of susceptibilities. Colistin and tigecycline are in many cases the unique options for the treatment of many episodes of VAP caused by MDR-GNB. Tigecyline (not licensed for treatment of pneumonia) should be used with an initial bolus of 200 mg followed by 100 mg every 12 h. The need for a loading dose and the administration of high doses of colistin (9 million IU/day in two or three doses) is currently accepted. Vancomycin has been considered the treatment of choice for pneumonia due to MRSA although linezolid may provide higher rate of clinical cure for MRSA VAP with a good safety profile. The initial antibiotic treatment must be reassessed and simplify in accordance of culture results.
Conclusions: Empirical treatment of VAP due to MDR pathogens should be based on knowledge of local ecology. A strategy combining early high doses of effective agents with subsequent simplification in the light of microbiologic information is recommended.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4289192 | PMC |
| http://dx.doi.org/10.1186/1471-2334-14-135 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A Retrospective Closed Cohort Study on Distribution of Multidrug-Resistant Bacteria in Ventilator-Associated Pneumonia and its Impact on Patient Outcome.
J Intensive Care Med
October 2024
Department of Anesthesia, Oman Medical Specialty Board, Muscat, Oman.
Objectives: Ventilator-associated pneumonia (VAP) is a common and serious nosocomial infection affecting critically ill patients undergoing mechanical ventilation. This study investigated the prevalence of multidrug-resistant (MDR) organisms in VAP, the VAP rate, and the outcomes associated with MDR-VAP.
Methods: This retrospective single-center study, conducted in 2022, included adult ICU cases from April 2021 to March 2022, receiving mechanical ventilation for more than 48 h.
Duration of antibiotic therapy for multidrug resistant Pseudomonas aeruginosa pneumonia: is shorter truly better?
BMC Infect Dis
September 2024
Department of Pharmacy Services, Jackson Memorial Hospital, Miami, FL, USA.
Background: The 2016 IDSA guideline recommends a treatment duration of at least 7 days for hospital-acquired (HAP)/ventilator-associated pneumonia (VAP). The limited literature has demonstrated higher rates of recurrence for non-glucose fermenting gram-negative bacilli with short course therapy, raising the concern of optimal treatment duration for these pathogens. Therefore, we aimed to compare the outcomes for patients receiving shorter therapy treatment (≤ 8 days) versus longer regimen (> 8 days) for the treatment of multidrug resistant (MDR) Pseudomonas pneumonia.
View Article and Find Full Text PDFOutcomes of adult patients with multidrug-resistant Acinetobacter baumannii ventilator-associated pneumonia treated with monotherapy versus combination therapy in a tertiary hospital.
Diagn Microbiol Infect Dis
November 2024
Division of Infectious Diseases, Department of Medicine, University of the Philippines - Philippine General Hospital, Taft Avenue, Manila, Philippines.
We compared clinical outcomes of patients who received monotherapy and combination therapy for treatment of MDR A. baumannii VAP. 170 patients were included.
View Article and Find Full Text PDFNovel Antibiotics for Gram-Negative Nosocomial Pneumonia.
Antibiotics (Basel)
July 2024
Department of Critical Care Medicine, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK.
Article Synopsis
- Nosocomial pneumonia, particularly hospital-acquired and ventilator-associated forms, is the top killer from hospital infections in critically ill patients, significantly exacerbated by multi-drug-resistant (MDR) Gram-negative bacteria (GNB).
- The rise of MDR-GNB pneumonia results in delayed treatments, longer hospital stays, and higher rates of illness and death, compounded by the toxic side effects of traditional antibiotics.
- Recently approved novel antibiotics show promise in treating MDR-GNB pneumonia, but rising antibiotic resistance poses a global challenge, emphasizing the need for careful usage to extend their effectiveness and evaluating their clinical efficacy specifically for patients with nosocomial pneumonia.
Patient-level cost analysis of intensive care unit acquired infections: A prospective cohort study.
J Hosp Infect
July 2024
Big Data, Program to Support the Institutional Development of the Unified Health System (PROADI-SUS), Hospital Israelita Albert Einstein, São Paulo, SP, Brazil; Post-graduation Program, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Introduction: Hospital-associated infections (HAIs) are associated with increased mortality and prolonged hospital length-of-stay (LOS). Although some studies have shown that HAIs are associated with increased costs, these studies only used cost estimates, were carried out in a small number of centres, or only in high-income countries.
Methods: We carried out a prospective cohort study in ten Brazilian intensive care units (ICUs) selected from a collaborative platform study (IMPACTO MR).
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!