Impact of Gram-positive resistance on outcome of nosocomial pneumonia.

Abstract:

:Among Gram-positive pathogens, Staphylococcus aureus is the leading cause of death from nosocomial pneumonia. The bacterium developed progressive resistance to beta-lactams, and methicillin-resistant strains emerged in the 1980s. In consequence, vancomycin has become the drug of choice for treatment of this infection over the last decade, based on susceptibility tests and the serum antimicrobial levels recorded. However, half of the patients treated with vancomycin have died. In contrast, in patients receiving beta-lactams for pneumonia caused by methicillin-sensitive S. aureus, survival is the rule. These observations, together with the emergence of isolates with reduced susceptibility to glycopeptides, raised concern about the use of vancomycin as standard therapy for pneumonia caused by Gram-positive cocci. Maintaining tissue levels above minimal inhibitory concentration is vital to successful clinical outcome. Optimizing treatment focusing on this goal and new antimicrobials provide new opportunities to improve survival. (Crit Care Med 2001; 29[Suppl.]:N82-N86)

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Bodi M,Ardanuy C,Rello J

doi

10.1097/00003246-200104001-00005

subject

Has Abstract

pub_date

2001-04-01 00:00:00

pages

N82-6

issue

4 Suppl

eissn

0090-3493

issn

1530-0293

journal_volume

29

pub_type

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