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| http://dx.doi.org/10.37201/req/s01.25.2022 | DOI Listing |
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Duration of Antimicrobial Treatment in Adult Patients with Pneumonia: A Narrative Review.
Antibiotics (Basel)
November 2024
First Department of Critical Care Medicine and Pulmonary Services, School of Medicine, Evangelismos Hospital, National and Kapodistrian University of Athens, 10676 Athens, Greece.
Pneumonia remains a major global health concern, causing significant morbidity and mortality among adults. This narrative review assesses the optimal duration of antimicrobial treatment in adults with community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), and ventilator-associated pneumonia (VAP). Current evidence about the impact of treatment duration on clinical outcomes demonstrates that shorter antibiotic courses are non-inferior, regarding safety and efficacy, compared to longer courses, particularly in patients with mild to moderate CAP, which is in line with the recommendations of international guidelines.
View Article and Find Full Text PDFCost-effectiveness of a short-course antibiotic treatment strategy for the treatment of ventilator-associated pneumonia: an economic analysis of the REGARD-VAP trial.
Lancet Glob Health
December 2024
National University Hospital, Singapore; Infectious Diseases Translational Research Program, National University of Singapore, Singapore; Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Background: The REGARD-VAP trial showed that individualised shortened antibiotic therapy was non-inferior to usual care for mortality and pneumonia recurrence in patients with ventilator-associated pneumonia (VAP). We aimed to assess the cost-effectiveness of an individualised shortened antibiotic therapy approach in this planned economic analysis.
Methods: REGARD-VAP was a phase 4, multicentre, open-label, randomised trial to assess a short-course antibiotic treatment strategy for treatment of VAP.
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 PDFChallenges Facing Two Outbreaks of Carbapenem-Resistant : From Cefiderocol Susceptibility Testing to the Emergence of Cefiderocol-Resistant Mutants.
Antibiotics (Basel)
August 2024
Critical Care Department, Hospital Universitario La Paz, IdiPAZ, 28046 Madrid, Spain.
Carbapenem-resistant (CRAB) infections are associated with poor outcomes depending on patient's conditions, clinical severity and type of infection, and treatment is challenging given the limited therapeutic options available. The aim of this study was to describe the clinical and microbiological characteristics of two outbreaks caused by CRAB in an intensive care unit (ICU). In addition, the mechanisms of resistance detected in these strains and the treatment chosen according to the available therapeutic options were analyzed.
View Article and Find Full Text PDFFrom Hemorrhage to Diarrhea: The Comprehensive Clinical Journey of a Patient With Pseudomembranous Colitis.
Cureus
July 2024
General Medicine, Saveetha Medical College and Hospital, Chennai, IND.
Article Synopsis
- Pseudomembranous colitis (PC) is an inflammation of the colon mainly caused by Clostridium difficile, often triggered by antibiotic use, as seen in a case involving a 48-year-old man with severe health issues who presented with acute weakness and later developed PC during hospitalization.* -
- The patient's condition deteriorated due to complications like ventilator-associated pneumonia from multi-drug resistant bacteria, but he successfully transitioned off mechanical ventilation before facing severe diarrhea and abdominal pain linked to PC, confirmed by stool tests and imaging.* -
- Despite an initial treatment plan including vancomycin and metronidazole, he experienced a relapse of PC, which was confirmed through colonoscopy; this case underscores the need
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