Clinical Guidelines for the Treatment of Nosocomial Pneumonia in Latin America: an Interdisciplinary Consensus Document

Luna, Carlos M.; Monteverde, Alfredo; Rodríguez, A.; Apezteguía, Carlos; Zabert, Gustavo; Ilutovich, Santiago; Menga, Guillermo; Vasen, Walter; Díez, Ana Rocasolano; Mera, Jorge

doi:10.1016/s1579-2129(06)60260-7

Cited by 10 publications

(15 citation statements)

References 267 publications

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“…Table 10 summarises the place of AMS in several published guidelines [124][125][126][127][128][129][130][131][132][133][134]. The combination is recommended as first-line treatment of community-and hospital-acquired pneumonia [128][129][130][131][132] (see Table 10 for specific scenarios) and of skin, fascia, and muscle with mixed infections [133]. It is also recommended as first-line therapy for infections following animal or human bites [133].…”

Section: Treatment Guidelinesmentioning

confidence: 99%

“…Hospital-acquired pneumonia ATS/IDSA [128] Recommended first-line treatment of 'hospital-acquired pneumonia or ventilator-associated pneumonia in patients with no known risk factors for multidrug-resistant pathogens, early onset, and any disease severity' Latin American Thoracic Society [129] Recommended first-line treatment of hospital-acquired pneumonia with a low risk of infection by resistant pathogens Recommended for the treatment of hospital-acquired pneumonia with Acinetobacter baumannii…”

Section: Guidelines Recommendationsmentioning

confidence: 99%

See 1 more Smart Citation

Rational antibiotic therapy and the position of ampicillin/sulbactam

Lode

2008

International Journal of Antimicrobial Agents

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Section: Treatment Guidelinesmentioning

confidence: 99%

Section: Guidelines Recommendationsmentioning

confidence: 99%

Rational antibiotic therapy and the position of ampicillin/sulbactam

Lode

2008

International Journal of Antimicrobial Agents

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“…The incidence of Acinetobacter spp. as the causative microorganism of VAP varies from one world area to other, from one city to other and even from one area in the hospital to another 9,10 …”

Section: Microbiologymentioning

confidence: 99%

Nosocomial Acinetobacter pneumonia

Luna

Aruj

2007

Respirology

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Acinetobacter spp. (A. baumannii is the prevalent genomic species, but others may cause infection) has become an increasingly important cause of nosocomial pneumonia, particularly in mechanically ventilated patients (VAP). This organism has intrinsic resistance to some antimicrobials but easily acquires resistance to many others; Acinetobacter spp. can survive for long periods of time in the environment. All of these characteristics have contributed to protracted outbreaks associated with significant morbidity and mortality. High rates of colonization are found in debilitated hospitalized patients. Infecting or colonizing organisms in nosocomial infections are more likely to be from cross-transmission or from the hospital environment than from endogenous sources. VAP caused by Acinetobacter spp. is emerging as a prominent hospital complication. The incidence of this microorganism varies from site to site, but it is the second commonest aetiological agent among the gram-negative bacteria. Longer periods of hospitalization, longer time on mechanical ventilation and prior use of antibiotics are the recognized factors increasing the risk of VAP due to Acinetobacter spp. Treatment needs to clearly differentiate infection from colonization, and the agents with the most antimicrobial activity are imipenem/cilastatin, amikacin, colistin, ampicillin/sulbactam and tigecycline. Monotherapy can be adequate if the patient does not have significant comorbidities. Infection control procedures have a major role to play in preventing transmission of this microorganism. Emphasis on initial control measures should, however, be on strict isolation of infected or colonized patients to limit dissemination of outbreak strains in the environment. The variety of potential sources of contamination with Acinetobacter spp. in the hospital environment makes control of these outbreaks one of the more difficult challenges. Persistence of Acinetobacter spp. in the environment provides ample opportunities for contamination of patients and staff and may explain continuing long-term outbreaks.

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“…These results were further filtered to identify guidelines published by a national professional society or professional medical association. Guidelines by the following organizations were identified: American Thoracic Society and Infectious Diseases Society of America [1], Latin American Thoracic Society [2], South African Thoracic Society [3], Japanese Respiratory Society [4], Portuguese Society of Pulmonology and Portuguese Intensive Care Society [5], Society Brasieira de Pulmonlogia [6], Association of Medical Microbiology and Infectious Diseases of Canada [7], and British Society for Antimicrobial Chemotherapy [8]. Only articles that were published in an English version [1,3,5,7,8] are included in this review.…”

Section: Methodsmentioning

confidence: 99%

Recommendations for Treatment of Hospital‐Acquired and Ventilator‐Associated Pneumonia: Review of Recent International Guidelines

File

2010

CLIN INFECT DIS

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Recently published guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia are reviewed for recommendations regarding diagnosis and antimicrobial therapy to assess the implications for development of future clinical trials. Despite some differences (mostly related to likely pathogens), there is a general agreement about the recommended approach to management. All of the reviewed guidelines invariably recommend early, appropriate antimicrobial therapy and avoidance of excessive antimicrobials by deescalation of therapy on the basis of microbiological culture results and the clinical response of the patient. Developers of future clinical trials will need to be mindful of these recommendations to maintain best practice care for each investigator.

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Clinical Guidelines for the Treatment of Nosocomial Pneumonia in Latin America: an Interdisciplinary Consensus Document

Cited by 10 publications

References 267 publications

Rational antibiotic therapy and the position of ampicillin/sulbactam

Rational antibiotic therapy and the position of ampicillin/sulbactam

Nosocomial Acinetobacter pneumonia

Recommendations for Treatment of Hospital‐Acquired and Ventilator‐Associated Pneumonia: Review of Recent International Guidelines

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