scholarly journals Hospital Acquired Pneumonia: Issues in Therapy

1994 ◽  
Vol 5 (suppl c) ◽  
pp. 15C-19C
Author(s):  
Lionel A Mandell
Keyword(s):  
Antimicrobial Agents ◽  
Single Agent ◽  
Severity Of Illness ◽  
Microbial Pathogens ◽  
Protected Specimen Brush ◽  
Treatment Regimens ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired ◽  
Agent Treatment ◽  
Selection Of

In December 1992. a meeting was convened in Toronto to develop guidelines for the initial treatment of hospital acquired pneumonia. Issues considered related lo the patient. the possible drugs used for treatment, and the pathogen(s). From the perspective of the patient. the two major issues were the presence or absence of risk factors for specific microbial pathogens and the severity of illness upon clinical presentation, Criteria for defining severly ill patients were developed and are presented in this paper. Drug and pathogen related issues focused on selection of antimicrobial agents thal would provide coverage for the likely pathogens. Concern was also expressed regarding use of aminoglycosides as single-agent treatment of Gram-negative infections in the lung. and the issue of monotherapy versus combination therapy ofPseudomonas aeruginosainfections was discussed. The use of various diagnostic tests was briefly reviewed. including the protected specimen brush and bronchoalveolar lavage. Treatment regimens are presented in tabular format.

scholarly journals In Vitro Comparison of Ceftolozane-Tazobactam to Traditional Beta-Lactams and Ceftolozane-Tazobactam as an Alternative to Combination Antimicrobial Therapy for Pseudomonas aeruginosa

2017 ◽  
Vol 61 (12) ◽  
Author(s):  
Kellie J. Goodlet ◽  
David P. Nicolau ◽  
Michael D. Nailor
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Single Agent ◽  
Cross Resistance ◽  
Combination Therapies ◽  
Beta Lactams ◽  
Content Type ◽  
Risk Patients ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

ABSTRACT Guidelines for the treatment of sepsis, febrile neutropenia, and hospital-acquired pneumonia caused by Pseudomonas aeruginosa include empirical regimens incorporating two antibiotics from different classes with activity against P. aeruginosa for select at-risk patients to increase the likelihood that the organism will be susceptible to at least one agent. The activity against P. aeruginosa and the rates of cross-resistance of ceftolozane-tazobactam were compared to those of the β-lactam comparators cefepime, ceftazidime, piperacillin-tazobactam, and meropenem alone and cumulatively with ciprofloxacin or tobramycin. Nonurine P. aeruginosa isolates were collected from adult inpatients at 44 geographically diverse U.S. hospitals. MICs were determined using reference broth microdilution methods. Of the 1,257 isolates collected, 29% were from patients in intensive care units and 39% were from respiratory sites. The overall rate of susceptibility to ceftolozane-tazobactam was high at 97%, whereas it was 72 to 76% for cefepime, ceftazidime, piperacillin-tazobactam, and meropenem. The rate of nonsusceptibility to all four comparator β-lactams was 11%; of the isolates nonsusceptible to the four comparator β-lactams, 80% remained susceptible to ceftolozane-tazobactam. Among the isolates nonsusceptible to the tested β-lactam comparators, less than half were susceptible to ciprofloxacin. By comparison, approximately 80% of the β-lactam-nonsusceptible isolates were susceptible to tobramycin, for overall cumulative susceptibility rates of 94 to 95%, nearly 10% higher than that of the ciprofloxacin–β-lactam combinations and approaching that of ceftolozane-tazobactam as a single agent. The rates of susceptibility to ceftolozane-tazobactam were consistently high, with little observable cross-resistance. Ceftolozane-tazobactam monotherapy performed at or above the level of commonly utilized combination therapies on the basis of in vitro susceptibilities. Ceftolozane-tazobactam should be considered for use in patients at high risk for resistant P. aeruginosa infection and as an alternative to empirical combination therapy, especially for patients unable to tolerate aminoglycosides.

scholarly journals Hospital acquired pneumonia: Microbial pathogens and antibiotic resistance trend

2021 ◽  
Vol 58 ◽  
pp. 21003058
Author(s):  
Van H. Pham ◽  
Chien D. Vo ◽  
Binh T. Pham ◽  
Hieu M. Pham ◽  
Duy K. Tran ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Microbial Pathogens ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

scholarly journals Hospital-Acquired Pneumonia: The Lebanese Societies for Pulmonary, Critical Care, and Infectious Diseases and Clinical Microbiology Joint Guidelines

2021 ◽  
Author(s):  
Moussa Riachy ◽  
Aline El Zakhem ◽  
Claude Afif ◽  
Jacques Choucair ◽  
Patricia Yazbeck ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Critical Care ◽  
Infectious Diseases ◽  
Patient Outcomes ◽  
Clinical Microbiology ◽  
Antimicrobial Agents ◽  
Stewardship Program ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired ◽  
Microbiological Data

Abstract Background: The Lebanese Society of Infectious Diseases and Clinical Microbiology (LSIDCM), the Lebanese Society of Critical Care Medicine (LSCCM), and the Lebanese Pulmonary Society (LPS) play a major role in guiding clinicians across Lebanon in prescribing antibiotics for the management of hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). Members of these societies have tailored the international recommendations for the management of HAP/VAP to local epidemiological and microbiological data. The aims of these local guidelines are to guide clinicians in the prevention of VAP, selection of appropriate empiric and targeted antimicrobial regimens for VAP/HAP and to contribute to improving patient outcomes. Methods: Recommendations in these guidelines are adapted from international guidelines and are modeled based on locally-derived epidemiological and microbiological data, as well as the availability of antimicrobial agents and other resources. Results: These guidelines aim to combine both clinical and bacteriological strategies to appropriately diagnose and manage HAP/VAP. They recommend implementing evidence-based preventive measures to lower the rate of VAP and improve patient outcomes. The recommended duration of treatment with antibiotics in general should not exceed 7 days in patients with HAP whereas it should be 7–8 days in patients with VAP. Imunnosuppressed patients with Pseudomonas aeruginosa infection might require longer courses. Ceftolozane/tazobactam (CFT/TAZ) and ceftazidime/avibactam (CAZ/AVI) are considered good options in patients with HAP/VAP caused by extended spectrum beta-lactamase-producing Enterobacterales and multidrug-resistant Pseudomonas aeruginosa. They also play a key role in the implementation of a carbapenem-sparing strategy in an antimicrobial stewardship program. Conclusion: These guidelines represent a major step towards establishing Lebanese national guidelines for the management of HAP/VAP. They also emphasize on timeliness and appropriateness of antibiotic therapy for the management of HAP/VAP.

scholarly journals The need for individual selection of probiotics containing lactobacilli and enterococci to increase the effectiveness of therapy for campylobacteriosis

2021 ◽  
pp. 88-93
Author(s):  
K. D. Ermolenko ◽  
N. P. Boldyreva ◽  
E. A. Martens ◽  
L. I. Zhelezova ◽  
S. V. Sidorenko ◽  
...  
Keyword(s):  
Antimicrobial Agents ◽  
Specific Activity ◽  
High Sensitivity ◽  
Saccharomyces Boulardii ◽  
Antagonistic Activity ◽  
Individual Selection ◽  
Treatment Regimens ◽  
Campylobacter Spp ◽  
Selection Of

The article highlights the problem of improving the rational treatment of campylobacteriosis. Probiotics are present in treatment regimens along with antibiotics, which have the advantage that they do not violate intestinal microbiocenosis and provide the ability to correct dysbiotic conditions. As well as antimicrobial agents, probiotics have different effects on the growth of pathogenic microorganisms. Campylobacter spp. probiotics in the in vitro system. The article studies the anticampylobacter activity of probiotic cultures of Enterococcus faecium L3, Lactobacillus plantarum 8 R-A3, a mixture of Lactobacillus acidophilus and Saccharomyces boulardii by two-layer agar and droplet method. Analysis of the antagonistic activity of chemically synthesized bacteriocins. The high sensitivity of Campylobacter spp was presented. to probiotics having lactobacilli and enterococci, as well as their metabolites (including bacteriocins). The strain-specific activity of probiotics and its dependence on their ability to produce bacteriocins were found. The results and data of other researchers indicate the need for individual selection of probiotics for the treatment of campylobacteriosis, the feasibility of analyzing the bacteriocinogenicity of the strains and testing their effect on the growth of clinical isolates.

scholarly journals Acinetobacter baumannii Infections in Hospitalized Patients, Treatment Outcomes

Antibiotics ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 630
Author(s):  
Diaa Alrahmany ◽  
Ahmed F. Omar ◽  
Gehan Harb ◽  
Wasim S. El El Nekidy ◽  
Islam M. Ghazi
Keyword(s):  
Acinetobacter Baumannii ◽  
Treatment Outcomes ◽  
Antibiotic Treatment ◽  
Financial Burden ◽  
Opportunistic Pathogen ◽  
Hospitalized Patients ◽  
Treatment Regimens ◽  
Serious Infections ◽  
Optimal Approach ◽  
Selection Of

Background Acinetobacter baumannii (AB), an opportunistic pathogen, could develop into serious infections with high mortality and financial burden. The debate surrounding the selection of effective antibiotic treatment necessitates studies to define the optimal approach. This study aims to compare the clinical outcomes of commonly used treatment regimens in hospitalized patients

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