Update of the treatment of nosocomial pneumonia in the ICU
Zaragoza, Rafael (Fundación Micellium, València)
Vidal-Cortés, Pablo (Complejo Hospitalario Universitario de Ourense)
Aguilar, Gerardo (Hospital Clínic Universitari (València))
Borges, Marcio (ICU, Hospital Universitario Son Llázter)
Díaz Santos, Emilio (Universitat Autònoma de Barcelona. Departament de Medicina)
Ferrer, Ricard (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Maseda, Emilio (Hospital Universitario La Paz (Madrid))
Nieto, Mercedes (Hospital Clínico San Carlos (Madrid))
Nuvials, Francisco Xavier (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Ramirez, Paula (Hospital Universitari i Politècnic La Fe (València))
Rodríguez, Alejandro (Hospital Universitari Joan XXIII de Tarragona)
Soriano, Cruz (Hospital Universitario Ramón y Cajal (Madrid))
Veganzones, Javier (Hospital Universitario La Paz (Madrid))
Martín-Loeches, Ignacio (St James's Hospital)

Fecha:	2020
Resumen:	In accordance with the recommendations of, amongst others, the Surviving Sepsis Campaign and the recently published European treatment guidelines for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), in the event of a patient with such infections, empirical antibiotic treatment must be appropriate and administered as early as possible. The aim of this manuscript is to update treatment protocols by reviewing recently published studies on the treatment of nosocomial pneumonia in the critically ill patients that require invasive respiratory support and patients with HAP from hospital wards that require invasive mechanical ventilation. An interdisciplinary group of experts, comprising specialists in anaesthesia and resuscitation and in intensive care medicine, updated the epidemiology and antimicrobial resistance and established clinical management priorities based on patients' risk factors. Implementation of rapid diagnostic microbiological techniques available and the new antibiotics recently added to the therapeutic arsenal has been reviewed and updated. After analysis of the categories outlined, some recommendations were suggested, and an algorithm to update empirical and targeted treatment in critically ill patients has also been designed. These aspects are key to improve VAP outcomes because of the severity of patients and possible acquisition of multidrug-resistant organisms (MDROs).
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	HAP ; VAP ; Nosocomial pneumonia ; Ceftolozane-tazobactam ; Ceftazidime-avibactam ; Pseudomonas aeruginosa ; KPC ; PCR
Publicado en:	Critical Care, Vol. 24 (june 2020) , ISSN 1466-609X

DOI: 10.1186/s13054-020-03091-2
PMID: 32600375

13 p, 1.1 MB

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