Abstract:
:Background We wanted to determine the impact of combined Clinical Pulmonary Infection Score (CPIS) and a spot serum procalcitonin (PCT)-guided protocol to shorten the duration of antibiotic treatment in patients with ventilator-associated pneumonia (VAP), mainly caused by nonfermentative gram-negative bacilli (NF-GNB). Methods Patients with VAP who received appropriate antibiotics for 7 days, temperature ⩽ 37.8°C, without shock, and CPIS ⩽ 6 were allocated to the PCT group or conventional group according to the treating physicians' decisions. In the PCT group, antibiotics were stopped if the PCT level on day 8 < 0.5 ng/ml. In the conventional group, antibiotics were stopped according to physicians' discretion. Results There were 24 patients in the PCT group and 26 patients in the conventional group. NF-GNB were responsible for VAP in 79.2% of the PCT group and 65.4% of the conventional group. PCT group had a greater number of antibiotic-free days alive during the 28 days after VAP onset than the conventional group (14.6 ± 5.4 days versus 5.9 ± 5.7 days, respectively; p <.001). In the multivariate, propensity score-adjusted analysis, the PCT group [coefficient = -9.1 (-12.2 to -6); p <.001] and extrapulmonary infections [coefficient = 6.4 (3.3-9.5); p <.001] were independent predictors of total antibiotic exposure days. There was no relapse in both groups. Meanwhile, 12.5% of the PCT group and 26.9% of the conventional group subsequently developed recurrent VAP compatible with superinfections. Conclusions CPIS and a spot serum PCT level appeared effective and safe to guide discontinuation of antibiotic treatment in patients with VAP caused by NF-GNB. TRIAL REGISTRATION:TCTR20160726002.
journal_name
Ther Adv Respir Disjournal_title
Therapeutic advances in respiratory diseaseauthors
Wongsurakiat P,Tulatamakit Sdoi
10.1177/1753466618760134subject
Has Abstractpub_date
2018-01-01 00:00:00pages
1753466618760134eissn
1753-4658issn
1753-4666journal_volume
12pub_type
杂志文章abstract:OBJECTIVE:Severe exacerbations in alpha-1-antitrypsin (AAT)-deficient patients with chronic obstructive pulmonary disease (COPD) and/or emphysema are a major cause of hospitalization. A multicentre, observational, retrospective study was undertaken to evaluate the effect of continuous AAT augmentation therapy in reduci...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章,多中心研究
doi:10.1177/1753465812438387
更新日期:2012-04-01 00:00:00
abstract::Allergen-specific immunotherapy remains the most likely effective treatment modality for allergic disorders by targeting the underlying immune mechanisms and possibly causing modifications in the disease course, as well as treating the symptoms. Treatment and compliance experiences been gained over nearly a century in...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章,评审
doi:10.1177/1753465809349522
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:Central airway obstruction (CAO) is a serious condition that affects patients with both benign and malignant diseases. Timely recognition of CAO is crucial for prompt intervention aimed at improving the symptoms and quality of life of these patients. The aim of this study is to evaluate the formal radiology ...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章
doi:10.1177/1753465815620111
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Disease severity may change in the first week after acute respiratory distress syndrome (ARDS) onset. The aim of this study was to evaluate whether the reclassification of disease severity after 48 h (i.e. day 3) of ARDS onset could help in predicting mortality and determine factors associated with ARDS pers...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章
doi:10.1177/1753466620936877
更新日期:2020-01-01 00:00:00
abstract::Immunotherapy has significantly altered the treatment landscape for many cancers, including non-small cell lung cancer (NSCLC). Currently approved immuno-oncology agents for lung cancer are aimed at the reversal of immune checkpoints, programmed death protein-1 (PD-1) and programmed death ligand-1 (PD-L1). Although re...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章,评审
doi:10.1177/1753466618794133
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:It is unclear whether microRNAs could be a potential diagnostic biomarker for asthma or not. The objective of this study is to figure out the diagnostic value of microRNAs in asthma. METHODS:Literature retrieval, screening of publications, specific data extraction, and quality evaluation were conducted acco...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章
doi:10.1177/1753466620981863
更新日期:2020-01-01 00:00:00
abstract::Programmed cell death (PD)-1 immune checkpoint inhibitors have emerged as promising options for the treatment of multiple cancer types. Nivolumab is a fully human immunoglobulin G4 monoclonal antibody, which inhibits the PD-1 receptor and has been approved in the United States, Europe, and Asia for the treatment of ad...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章,评审
doi:10.1177/1753466618801167
更新日期:2018-01-01 00:00:00
abstract::Rheumatoid arthritis (RA) is an inflammatory autoimmune disease that can present different extrarticular manifestations involving heart, lungs and kidneys. In recent years there has been a growing awareness of the central role played by the lungs in the onset and progression of RA. In particular interstitial lung dise...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章,评审
doi:10.1177/1753465816668780
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Comorbidities probably contribute to the increased mortality observed among subjects with chronic obstructive pulmonary disease (COPD), but sex differences in the prognostic impact of comorbidities have rarely been evaluated in population-based studies. The aim of this study was to evaluate the impact of com...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章
doi:10.1177/1753466619860058
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:Our aim was to determine the influence of pulmonary rehabilitation conducted in therapeutic salt mine chambers on the functional fitness of older adults. METHODS:The study included 22 individuals of age >65 years with chronic respiratory conditions. The patients underwent the Fullerton test before and after ...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章
doi:10.1177/1753466620926952
更新日期:2020-01-01 00:00:00
abstract::It is well established that smoking is the primary preventable cause of disease and death in the United States and that it is responsible for a wide range of negative health consequences, including but not limited to respiratory disease. According to the US Public Health Service, all patients attempting to quit smokin...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章,评审
doi:10.1177/1753465809353768
更新日期:2010-02-01 00:00:00
abstract::COPD may be characterized by significant changes in airway mucosal blood vessels, which may contribute to bronchial airway remodeling. The airway wall is more vascularized in COPD patients than in healthy subjects, though this phenomenon is less evident than in asthmatic patients. The vascular mucosal changes in the a...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章,评审
doi:10.1177/1753465808092339
更新日期:2008-06-01 00:00:00
abstract::Fluoroquinolones are commonly used to treat lung infections in patients with cystic fibrosis. These patients are susceptible to lung infection with common bacteria such as Staphylococcus aureus and Haemophilus influenzae, but are also prone to infection by opportunistic bacteria, including Pseudomonas aeruginosa. The ...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章,评审
doi:10.1177/1753465812459899
更新日期:2012-12-01 00:00:00
abstract::Within telehealth there are a number of domains relevant to pulmonary care: telemonitoring, teleassistance, telerehabilitation, teleconsultation and second opinion calls. In the last decade, several studies focusing on the effects of various telemanagement programs for patients with chronic obstructive pulmonary disea...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章,评审
doi:10.1177/1753465818754778
更新日期:2018-01-01 00:00:00
abstract::Avoidance of allergens in the treatment of asthma has hitherto not achieved significant benefit despite the strong evidence that allergy both increases severity and contributes to exacerbations of asthma. House dust mite, cat and dog allergens are the most common perennial allergic triggers and most avoidance strategi...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章,评审
doi:10.1177/1753465817690505
更新日期:2017-04-01 00:00:00
abstract::Bronchiectasis occurs as a result of a vicious circle consisting of an impaired mucociliary transport system, inflammation, and infection and repair of the airways. Damage to the mucociliary system prevents secretion elimination and facilitates bacterial growth and bronchial inflammation. To facilitate mucociliary cle...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章,评审
doi:10.1177/1753466619866102
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Endoscopic lung volume reduction coil (LVRC) treatment is a therapeutic option for selected patients with advanced emphysema. The effects and the safety of endoscopic lung volume reduction in patients with very low forced expired volume in one second (FEV1) remain to be determined. This study was conducted t...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章
doi:10.1177/1753466618760133
更新日期:2018-01-01 00:00:00
abstract::As our understanding of the pathobiology and natural history of the various forms of interstitial lung disease (ILD) has evolved, so have our approaches to treating this heterogeneous group of lung disorders. The earliest pharmacologic agents used to treat various forms of ILD were corticosteroids, and corticosteroids...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章,评审
doi:10.1177/1753465808096948
更新日期:2008-10-01 00:00:00
abstract::The issue of electronic cigarettes is one of the most controversial topics in public health. There is intense debate and dividing opinions about their use patterns, health effects and association with smoking. This is expected since they were only recently introduced to the market and they refer to a harm-reduction ap...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章,评审
doi:10.1177/1753465817744960
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVES:Pharmacologically mediated bronchodilation is important in the management of asthma, and is primarily achieved with β₂-agonists. Novel compounds should preferably have a longer duration of action and a better systemic side effect profile than established alternatives at comparable peak bronchodilation. This ...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1177/1753465813497527
更新日期:2013-10-01 00:00:00
abstract::There is evidence of aberrations in the vitamin D-endocrine system in subjects with respiratory diseases. Vitamin D deficiency is highly prevalent in patients with respiratory diseases, and patients who receive vitamin D have significantly larger improvements in inspiratory muscle strength and maximal oxygen uptake. S...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章,评审
doi:10.1177/1753465813503029
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Bacterial pneumonia is a major cause of acute respiratory distress syndrome (ARDS) requiring extracorporeal membrane oxygenation (ECMO) support. However, it is unknown whether the type of pneumonia, community-acquired pneumonia (CAP) versus hospital-acquired pneumonia (HAP), should be considered when predict...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章
doi:10.1177/1753466618821038
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Pseudomonas aeruginosa (Pa) is the predominant pulmonary pathogen in patients with cystic fibrosis (CF). Tobramycin nebulization is used for the eradication of Pa infection. Nowadays, tobramycin dry powder inhalation (DPI) is available as well. This study reports the results of eradicating Pa with tobramycin...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章
doi:10.1177/1753466620905279
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal interstitial lung disease (ILD). Currently, two antifibrotic drugs are available for reducing forced vital capacity (FVC) decline in IPF. However, many pulmonologists wait before initiating treatment, especially when IPF patients have stable dise...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章
doi:10.1177/1753466620953783
更新日期:2020-01-01 00:00:00
abstract::The use of biomarkers on pleural fluid (PF) specimens may assist the decision-making process and enhance clinical diagnostic pathways. Three paradigmatic examples are heart failure, tuberculosis and, particularly, malignancy. An elevated PF concentration of the amino-terminal fragment of probrain natriuretic peptide (...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章,评审
doi:10.1177/1753466618808660
更新日期:2018-01-01 00:00:00
abstract::Pregnancy may be complicated by new onset or preexisting asthma. This article reviews the recognition and management of asthma during pregnancy, as well as general principles of asthma medication use during pregnancy. ...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章
doi:10.1177/1753465814540029
更新日期:2014-08-01 00:00:00
abstract::Pulmonary arterial hypertension (PAH) is a chronic condition of elevated pulmonary arterial pressures with associated increases in pulmonary vascular resistance leading to right ventricular failure, which was almost uniformly fatal prior to the introduction of pulmonary hypertension specific therapy. Systemic prostacy...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章,评审
doi:10.1177/1753465812455368
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVES:To describe the health-related quality of life (HRQL) in a cohort of COPD patients recruited in primary care and identify the variables of the patients and the treatment associated with impaired HRQL. METHOD:Multicenter, observational study of patients with COPD recruited in Primary Care centers. Data regar...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章,多中心研究
doi:10.1177/1753465807086097
更新日期:2007-12-01 00:00:00
abstract::Current guidelines for the management of chronic obstructive pulmonary disease (COPD) establish that bronchodilator medications are central to the symptomatic treatment of the disease. Regular treatment with long-acting bronchodilators is recommended as more effective and convenient than short-acting bronchodilators, ...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章,评审
doi:10.1177/1753465810387810
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVES:Both autofluorescence imaging bronchoscopy and narrow-band imaging have shown promise in the detection of premalignant airway lesions, each by utilizing different bandwidths of lights for better characterization of the mucosal and submucosal vascular grid. Since previously published meta-analyses have shown ...
journal_title:Therapeutic advances in respiratory disease
pub_type: 杂志文章,meta分析
doi:10.1177/1753465815589698
更新日期:2015-10-01 00:00:00