Abstract:
BACKGROUND:The increasing occurrence of multidrug resistant (MDR) bacteria arises at a time when there is a lack of antibiotics active against these pathogens and few new antimicrobials are in the pipelines of the pharmaceutical industry. Treatment of ventilator-associated pneumonia (VAP) caused especially by MDR Gram-negative bacilli (GNB) represents a real challenge due to the dearth of treatment options. METHODS:We searched the medical literature relevant about management of ventilator-associated pneumonia caused by multi-drug resistant pathogens including GNB and methicillin-resistant S. aureus. RESULTS:Empirical therapy should be prescribed based on the local pattern of susceptibilities. Colistin and tigecycline are in many cases the unique options for the treatment of many episodes of VAP caused by MDR-GNB. Tigecyline (not licensed for treatment of pneumonia) should be used with an initial bolus of 200 mg followed by 100 mg every 12 h. The need for a loading dose and the administration of high doses of colistin (9 million IU/day in two or three doses) is currently accepted. Vancomycin has been considered the treatment of choice for pneumonia due to MRSA although linezolid may provide higher rate of clinical cure for MRSA VAP with a good safety profile. The initial antibiotic treatment must be reassessed and simplify in accordance of culture results. CONCLUSIONS:Empirical treatment of VAP due to MDR pathogens should be based on knowledge of local ecology. A strategy combining early high doses of effective agents with subsequent simplification in the light of microbiologic information is recommended.
journal_name
BMC Infect Disjournal_title
BMC infectious diseasesauthors
Garnacho-Montero J,Corcia-Palomo Y,Amaya-Villar R,Martin-Villen Ldoi
10.1186/1471-2334-14-135subject
Has Abstractpub_date
2014-11-28 00:00:00pages
135issn
1471-2334pii
1471-2334-14-135journal_volume
14pub_type
杂志文章abstract:BACKGROUND:Diabetes mellitus (DM) is recognized as an important comorbidity for the development of tuberculosis (TB). With the increase of DM burden globally, concerns have been raised about the emerging co-epidemics of DM and TB, especially in low- and middle-income countries. METHODS:A facility-based, cross-sectiona...
journal_title:BMC infectious diseases
pub_type: 杂志文章
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pub_type: 杂志文章,meta分析,评审
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journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-14-29
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doi:10.1186/s12879-016-1864-9
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pub_type: 杂志文章
doi:10.1186/s12879-018-3044-6
更新日期:2018-04-02 00:00:00
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doi:10.1186/1471-2334-14-382
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pub_type: 杂志文章
doi:10.1186/1471-2334-14-270
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pub_type: 杂志文章,meta分析
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pub_type: 杂志文章
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更新日期:2012-12-19 00:00:00
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journal_title:BMC infectious diseases
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更新日期:2017-06-06 00:00:00
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journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-016-1909-0
更新日期:2016-10-19 00:00:00