Neumonía intrahospitalaria: guía clínica aplicable a Latinoamérica preparada en común por diferentes especialistas

Antibiotic Utilization Study in Patients With Nosocomial Pneumonia in a Pediatric Hospital in Pachuca, Hidalgo

“…The spread of bacterial resistance due to changes in hospital epidemiology forces the need for new antibiotic treament strategies. The establishment of clinical guidelines by consensus is usually very effective as is the case in Latin America 8 .…”

“…It considers the patient´s clinical data, previous antibiotic therapy, time of hospital stay, the prevalence of pathogens and their natural and hospital resistance patterns with the aim of providing timely and appropriate treatment, in addition to establishing rational antibiotic use to prevent the development of bacterial resistance [8][9][10] . Even though treatment in the DIF Pediatric Hospital Hidalgo has been prescribed considering previous antibiotic therapy, time of hospital stay, and underlying diseases, it is essential to consider the hospital´s epidemiology and apply it in a clinical guideline that supports current empirical treatment and its duration (treatment interruption and changes in treatment schemes) taking into consideration the recommendations for the aforementioned guide as in the case of changes in treatment schemes before 72 hours.…”

“…Even though treatment in the DIF Pediatric Hospital Hidalgo has been prescribed considering previous antibiotic therapy, time of hospital stay, and underlying diseases, it is essential to consider the hospital´s epidemiology and apply it in a clinical guideline that supports current empirical treatment and its duration (treatment interruption and changes in treatment schemes) taking into consideration the recommendations for the aforementioned guide as in the case of changes in treatment schemes before 72 hours. 8 Identifying the causal agent favors focused antimicrobial therapy. With this we can reevaluate the use and dose of broadspectrum antibiotics making it possible to reduce the spectrum with a subsequent reduction in cost.…”

“…There is a direct relationship between antibiotic use and the increase in resistance of enterobacteria such as P. aeruginosa, vancomycin-resistant enterococcus, Klebsiella, and methicillin-resistant S. aureus, among others 8,9 . According to a study by Luna et al, inadequate treatment in the first 48 hours is associated with greater mortality (91%), while with appropriate treatment, mortality decreases to 38% 10 …”

Neumonía comunitaria por Proteus mirabilis

“…Se cree que el germen alcanza la vía aérea por inhalación, implicán-dose el papel de la colonización intestinal como posible reservorio (1). El papel de este como patógeno nosocomial ha sido descrito en varias ocasiones (2). Existe según nuestra información, un único caso de infección comunitaria por éste germen (3).…”