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Zaragoza R, Vidal-Cortés P, Aguilar G, Borges M, Diaz E, Ferrer R, Maseda E, Nieto M, Nuvials FX, Ramirez P, Rodriguez A, Soriano C, Veganzones J, Martín-Loeches I. Update of the treatment of nosocomial pneumonia in the ICU. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2020; 24:383. [PMID: 32600375 PMCID: PMC7322703 DOI: 10.1186/s13054-020-03091-2] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 06/12/2020] [Indexed: 12/19/2022]
Abstract
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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Affiliation(s)
- Rafael Zaragoza
- Critical Care Department, Hospital Universitario Dr. Peset, Valencia, Spain. .,Fundación Micellium, Valencia, Spain.
| | | | - Gerardo Aguilar
- SICU, Hospital Clínico Universitario Valencia, Valencia, Spain
| | - Marcio Borges
- Fundación Micellium, Valencia, Spain.,ICU, Hospital Universitario Son Llázter, Palma de Mallorca, Spain
| | - Emili Diaz
- Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.,Critical Care Department, Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain.,CIBERES Ciber de Enfermedades Respiratorias, Madrid, Spain
| | | | - Emilio Maseda
- Fundación Micellium, Valencia, Spain.,SICU, Hospital Universitario La Paz, Madrid, Spain
| | - Mercedes Nieto
- ICU, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | | | - Paula Ramirez
- ICU, Hospital Universitari I Politecnic La Fe, Valencia, Spain
| | | | - Cruz Soriano
- ICU, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - Ignacio Martín-Loeches
- ICU, Trinity Centre for Health Science HRB-Wellcome Trust, St James's Hospital, Dublin, Ireland
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García-Lozano T, Pascual-Plá FJ, Martín-Utrilla S, Egido-González A. [Study of clinical variables predictive of nosocomial pneumonia by methicillin-resistant Staphylococcus aureus]. REVISTA DE CALIDAD ASISTENCIAL : ORGANO DE LA SOCIEDAD ESPANOLA DE CALIDAD ASISTENCIAL 2016; 31:243-244. [PMID: 26709000 DOI: 10.1016/j.cali.2015.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 10/09/2015] [Accepted: 10/16/2015] [Indexed: 06/05/2023]
Affiliation(s)
- T García-Lozano
- Servicio de Análisis Clínicos y Microbiología, Laboratorio de Diagnóstico Clínico, Fundación Instituto Valenciano de Oncología (FIVO), Valencia, España; Universidad Católica de Valencia «San Vicente Mártir», Valencia, España.
| | - F J Pascual-Plá
- Servicio de Urgencias, Fundación Instituto Valenciano de Oncología (FIVO), Valencia, España
| | - S Martín-Utrilla
- Unidad de Hospitalización Domiciliaria, Fundación Instituto Valenciano de Oncología (FIVO), Valencia, España
| | - A Egido-González
- Unidad de Medicina Interna, Fundación Instituto Valenciano de Oncología (FIVO), Valencia, España
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Navalpotro Rodríguez D, Gimeno Cardona C. Incorporación del estado de portador de Staphylococcus aureus resistente a meticilina en la predicción clínica de la neumonía nosocomial. Med Clin (Barc) 2012; 139:417-8. [DOI: 10.1016/j.medcli.2012.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 04/19/2012] [Accepted: 04/26/2012] [Indexed: 11/28/2022]
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Carrero Gras A, Eiros Bouza JM, Carrero González P, Hernando Real S. Bacteriemia por Staphylococcus aureus resistente a meticilina de origen respiratorio. Med Clin (Barc) 2012; 139:462-3; author reply 463-4. [DOI: 10.1016/j.medcli.2012.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Revised: 05/05/2012] [Accepted: 05/10/2012] [Indexed: 10/28/2022]
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