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Erschienen in: Intensive Care Medicine 11/2005

01.11.2005 | Editorial

Antibiotic prescribing for ventilator-associated pneumonia: get it right from the beginning but be able to rapidly deescalate

verfasst von: Jean Chastre

Erschienen in: Intensive Care Medicine | Ausgabe 11/2005

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Excerpt

Ventilator-associated pneumonia (VAP) is the most frequent ICU-acquired infection among patients receiving mechanical ventilation (MV) [1, 2]. While controversy continues regarding the mortality due to this process, multiple studies have documented that VAP increases both ICU length of stay and MV duration [1, 3, 4, 5]. VAP also contributes significantly to costs in the ICU. For example, two recent analyses suggest that VAP adds some $40,000 in costs per case [3, 5]. Approximately 50% of antibiotics prescribed in ICUs are administered for respiratory tract infections [6]. …
Literatur
1.
Zurück zum Zitat Chastre J, Fagon JY (2002) Ventilator-associated pneumonia. Am J Respir Crit Care Med 165:867–903PubMed Chastre J, Fagon JY (2002) Ventilator-associated pneumonia. Am J Respir Crit Care Med 165:867–903PubMed
2.
Zurück zum Zitat Anonymous (2005) Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med 171:388–416CrossRefPubMed Anonymous (2005) Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med 171:388–416CrossRefPubMed
3.
Zurück zum Zitat Warren DK, Shukla SJ, Olsen MA, Kollef MH, Hollenbeak CS, Cox MJ, Cohen MM, Fraser VJ (2003) Outcome and attributable cost of ventilator-associated pneumonia among intensive care unit patients in a suburban medical center. Crit Care Med 31:1312–1317CrossRefPubMed Warren DK, Shukla SJ, Olsen MA, Kollef MH, Hollenbeak CS, Cox MJ, Cohen MM, Fraser VJ (2003) Outcome and attributable cost of ventilator-associated pneumonia among intensive care unit patients in a suburban medical center. Crit Care Med 31:1312–1317CrossRefPubMed
4.
Zurück zum Zitat Rello J, Ollendorf DA, Oster G, Vera-Llonch M, Bellm L, Redman R, Kollef MH (2002) Epidemiology and outcomes of ventilator-associated pneumonia in a large US database. Chest 122:2115–2121CrossRefPubMed Rello J, Ollendorf DA, Oster G, Vera-Llonch M, Bellm L, Redman R, Kollef MH (2002) Epidemiology and outcomes of ventilator-associated pneumonia in a large US database. Chest 122:2115–2121CrossRefPubMed
5.
Zurück zum Zitat Hugonnet S, Eggimann P, Borst F, Maricot P, Chevrolet JC, Pittet D (2004) Impact of ventilator-associated pneumonia on resource utilization and patient outcome. Infect Control Hosp Epidemiol 25:1090–1096PubMed Hugonnet S, Eggimann P, Borst F, Maricot P, Chevrolet JC, Pittet D (2004) Impact of ventilator-associated pneumonia on resource utilization and patient outcome. Infect Control Hosp Epidemiol 25:1090–1096PubMed
6.
Zurück zum Zitat Bergmans DC, Bonten MJ, Gaillard CA, van Tiel FH, van der Geest S, de Leeuw PW, Stobberingh EE (1997) Indications for antibiotic use in ICU patients: a one-year prospective surveillance. J Antimicrob Chemother 39:527–535CrossRefPubMed Bergmans DC, Bonten MJ, Gaillard CA, van Tiel FH, van der Geest S, de Leeuw PW, Stobberingh EE (1997) Indications for antibiotic use in ICU patients: a one-year prospective surveillance. J Antimicrob Chemother 39:527–535CrossRefPubMed
7.
Zurück zum Zitat Iregui M, Ward S, Sherman G, Fraser VJ, Kollef MH (2002) Clinical importance of delays in the initiation of appropriate antibiotic treatment for ventilator-associated pneumonia. Chest 122:262–268CrossRefPubMed Iregui M, Ward S, Sherman G, Fraser VJ, Kollef MH (2002) Clinical importance of delays in the initiation of appropriate antibiotic treatment for ventilator-associated pneumonia. Chest 122:262–268CrossRefPubMed
8.
Zurück zum Zitat Niederman MS (2003) Appropriate use of antimicrobial agents: challenges and strategies for improvement. Crit Care Med 31:608–616CrossRefPubMed Niederman MS (2003) Appropriate use of antimicrobial agents: challenges and strategies for improvement. Crit Care Med 31:608–616CrossRefPubMed
9.
Zurück zum Zitat Kollef MH (2003) Appropriate antibiotic therapy for ventilator-associated pneumonia and sepsis: a necessity, not an issue for debate. Intensive Care Med 29:147–149PubMed Kollef MH (2003) Appropriate antibiotic therapy for ventilator-associated pneumonia and sepsis: a necessity, not an issue for debate. Intensive Care Med 29:147–149PubMed
10.
Zurück zum Zitat Kollef MH, Ward S, Sherman G, Prentice D, Schaiff R, Huey W, Fraser VJ (2000) Inadequate treatment of nosocomial infections is associated with certain empiric antibiotic choices. Crit Care Med 28:3456–3464CrossRefPubMed Kollef MH, Ward S, Sherman G, Prentice D, Schaiff R, Huey W, Fraser VJ (2000) Inadequate treatment of nosocomial infections is associated with certain empiric antibiotic choices. Crit Care Med 28:3456–3464CrossRefPubMed
11.
Zurück zum Zitat Giantsou E, Liratzopoulos N, Efraimidou E, Panopoulou M, Alepopoulou E, Kartali-Ktenidou S, Minopoulos GI, Zakynthinos SP, Manolas MI (2005) Both early and late-onset ventilator-associated pneumonia are mainly cause by potentially multiresistant bacteria. Intensive Care Med (s00134-005-2697-4) Giantsou E, Liratzopoulos N, Efraimidou E, Panopoulou M, Alepopoulou E, Kartali-Ktenidou S, Minopoulos GI, Zakynthinos SP, Manolas MI (2005) Both early and late-onset ventilator-associated pneumonia are mainly cause by potentially multiresistant bacteria. Intensive Care Med (s00134-005-2697-4)
12.
Zurück zum Zitat Ibrahim EH, Ward S, Sherman G, Schaiff R, Fraser VJ, Kollef MH (2001) Experience with a clinical guideline for the treatment of ventilator-associated pneumonia. Crit Care Med 29:1109–1115CrossRefPubMed Ibrahim EH, Ward S, Sherman G, Schaiff R, Fraser VJ, Kollef MH (2001) Experience with a clinical guideline for the treatment of ventilator-associated pneumonia. Crit Care Med 29:1109–1115CrossRefPubMed
13.
Zurück zum Zitat Rello J, Sa-Borges M, Correa H, Leal SR, Baraibar J (1999) Variations in etiology of ventilator-associated pneumonia across four treatment sites: implications for antimicrobial prescribing practices. Am J Respir Crit Care Med 160:608–613PubMed Rello J, Sa-Borges M, Correa H, Leal SR, Baraibar J (1999) Variations in etiology of ventilator-associated pneumonia across four treatment sites: implications for antimicrobial prescribing practices. Am J Respir Crit Care Med 160:608–613PubMed
14.
Zurück zum Zitat Trouillet JL, Chastre J, Vuagnat A, Joly-Guillou ML, Combaux D, Dombret MC, Gibert C (1998) Ventilator-associated pneumonia caused by potentially drug-resistant bacteria. Am J Respir Crit Care Med 157:531–539PubMed Trouillet JL, Chastre J, Vuagnat A, Joly-Guillou ML, Combaux D, Dombret MC, Gibert C (1998) Ventilator-associated pneumonia caused by potentially drug-resistant bacteria. Am J Respir Crit Care Med 157:531–539PubMed
15.
Zurück zum Zitat Tablan OC, Anderson LJ, Besser R, Bridges C, Hajjeh R (2004) Guidelines for preventing health-care-associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR Recomm Rep 53:1–36 Tablan OC, Anderson LJ, Besser R, Bridges C, Hajjeh R (2004) Guidelines for preventing health-care-associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR Recomm Rep 53:1–36
16.
Zurück zum Zitat Paterson DL (2004) “Collateral damage” from cephalosporin or quinolone antibiotic therapy. Clin Infect Dis 38 [Suppl 4]:S341–S345 Paterson DL (2004) “Collateral damage” from cephalosporin or quinolone antibiotic therapy. Clin Infect Dis 38 [Suppl 4]:S341–S345
17.
Zurück zum Zitat EORTC International Antimicrobial Therapy Cooperative Group (1987) Ceftazidime combined with a short or long course of amikacin for empirical therapy of gram-negative bacteremia in cancer patients with granulocytopenia. N Engl J Med 317:1692–1698PubMed EORTC International Antimicrobial Therapy Cooperative Group (1987) Ceftazidime combined with a short or long course of amikacin for empirical therapy of gram-negative bacteremia in cancer patients with granulocytopenia. N Engl J Med 317:1692–1698PubMed
18.
Zurück zum Zitat Korvick JA, Bryan CS, Farber B, Beam TR, Schenfeld L, Muder RR, Weinbaum D, Lumish R, Gerding DN, Wagner MM, et al (1992) Prospective observational study of Klebsiella bacteremia in 230 patients: outcome for antibiotic combinations versus monotherapy. Antimicrob Agents Chemother 36:2639–2644PubMed Korvick JA, Bryan CS, Farber B, Beam TR, Schenfeld L, Muder RR, Weinbaum D, Lumish R, Gerding DN, Wagner MM, et al (1992) Prospective observational study of Klebsiella bacteremia in 230 patients: outcome for antibiotic combinations versus monotherapy. Antimicrob Agents Chemother 36:2639–2644PubMed
19.
Zurück zum Zitat Paul M, Soares-Weiser K, Leibovici L (2003) Beta lactam monotherapy versus beta lactam-aminoglycoside combination therapy for fever with neutropenia: systematic review and meta-analysis. BMJ 326:1111CrossRefPubMed Paul M, Soares-Weiser K, Leibovici L (2003) Beta lactam monotherapy versus beta lactam-aminoglycoside combination therapy for fever with neutropenia: systematic review and meta-analysis. BMJ 326:1111CrossRefPubMed
20.
Zurück zum Zitat Chastre J, Wolff M, Fagon JY, Chevret S, Thomas F, Wermert D, Clementi E, Gonzalez J, Jusserand D, Asfar P, Perrin D, Fieux F, Aubas S, PneumA Trial Group l (2003) Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial. JAMA 290:2588–2598CrossRefPubMed Chastre J, Wolff M, Fagon JY, Chevret S, Thomas F, Wermert D, Clementi E, Gonzalez J, Jusserand D, Asfar P, Perrin D, Fieux F, Aubas S, PneumA Trial Group l (2003) Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial. JAMA 290:2588–2598CrossRefPubMed
21.
Zurück zum Zitat Micek ST, Ward S, Fraser VJ, Kollef MH (2004) A randomized controlled trial of an antibiotic discontinuation policy for clinically suspected ventilator-associated pneumonia. Chest 125:1791–1799CrossRefPubMed Micek ST, Ward S, Fraser VJ, Kollef MH (2004) A randomized controlled trial of an antibiotic discontinuation policy for clinically suspected ventilator-associated pneumonia. Chest 125:1791–1799CrossRefPubMed
Metadaten
Titel
Antibiotic prescribing for ventilator-associated pneumonia: get it right from the beginning but be able to rapidly deescalate
verfasst von
Jean Chastre
Publikationsdatum
01.11.2005
Verlag
Springer-Verlag
Erschienen in
Intensive Care Medicine / Ausgabe 11/2005
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-005-2696-z

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