Update of the treatment of nosocomial pneumonia in the ICU

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 trea...

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Detalles Bibliográficos
Autores: Zaragoza, Rafael|||0000-0002-6593-5486, Vidal-Cortés, Pablo|||0000-0003-0225-9975, Aguilar, Gerardo|||0000-0001-7997-4294, Borges, Marcio, Díaz Santos, Emilio|||0000-0003-3637-3821, Ferrer, Ricard|||0000-0002-4859-4747, Maseda, Emilio|||0000-0003-2898-7073, Nieto, Mercedes, Nuvials, Francisco Xavier, Ramírez, Paula|||0000-0002-7598-3350, Rodríguez, Alejandro, Soriano, Cruz, Veganzones, Javier, Martín-Loeches, Ignacio
Tipo de recurso: artículo
Fecha de publicación:2020
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:252715
Acceso en línea:https://ddd.uab.cat/record/252715
https://dx.doi.org/urn:doi:10.1186/s13054-020-03091-2
Access Level:acceso abierto
Palabra clave:HAP
VAP
Nosocomial pneumonia
Ceftolozane-tazobactam
Ceftazidime-avibactam
Pseudomonas aeruginosa
KPC
PCR
Descripción
Sumario: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).

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