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Systemic antibiotic treatment of nosocomial pneumonia.

Abstract：

:Nosocomial pneumonia continues to represent a significant cause of morbidity and mortality in hospitalized patients. Bacteria are responsible for greater than 90% of the pneumonias, the most common isolates being aerobic Gram-negative bacilli and S. aureus. Cornerstones of treatment are intravenous antibiotics and supportive care. In the individual case the true etiology is usually unknown; therefore empiric broad spectrum treatment is commonly used based on the prevalence of local pathogens, their antibiotic sensitivity pattern and on host factors. Combination antibiotic regimens, including beta-lactams and aminoglycosides, are considered as standard therapy and are associated with clinical success rates of greater than 80%. Monotherapy with broad spectrum antibiotics, such as third generation cephalosporins, imipenem and fluoroquinolones, can be considered as equally effective in non-neutropenic patients and in the absence of P. aeruginosa infection. More active and less toxic antibiotics are still needed for problematic pathogens such as methicillin-resistant S. aureus strains, multiresistant Enterobacteriaceae and Pseudomonas species. Because further improvement in morbidity and mortality may be limited with antibiotics alone, new emphasis should be placed on prevention of infection and the use of immunotherapy.

journal_name

Intensive Care Med

journal_title

Intensive care medicine

authors

Unertl KE,Lenhart FP,Forst H,Peter K

doi

10.1007/BF01752974

keywords:

subject

Has Abstract

pub_date

1992-01-01 00:00:00

pages

S28-34

eissn

0342-4642

issn

1432-1238

journal_volume

18 Suppl 1

pub_type

杂志文章,评审

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