Prescribing Patterns of Drugs in Acute Respiratory Distress Syndrome (ARDS): An Observational Study

Rao, S. D. Thirumala; Chogtu, Bharti

doi:10.7860/jcdr/2015/10411.5519

Cited by 5 publications

(3 citation statements)

References 34 publications

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“…Hence, through assessing the use of antibiotics and steroids for the ARDS, it will be helpful to come up with further antibiotics policies and treatment guidelines. A previous study from our setting by Magazine R et al recorded that all ARDS patients were prescribed antibiotics and 41.3% were prescribed corticosteroids [32].…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 90%

Factors affecting the outcomes in patients with acute respiratory distress syndrome in a tertiary care setting

Rashid

Ramakrishnan

Muthu

et al. 2022

Clinical Epidemiology and Global Health

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 90%

Factors affecting the outcomes in patients with acute respiratory distress syndrome in a tertiary care setting

Rashid

Ramakrishnan

Muthu

et al. 2022

Clinical Epidemiology and Global Health

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“…1A ). The resultant untailored, broad-spectrum antibiotics (typically targeting Gram-positive/negative and atypical bacteria) can be disproportionately intense, inadequate, or entirely unnecessary, depending on the causative microbial agent ( 4 ). Such intense regimens also increase the risk of toxicity, ablate indigenous protective microbiota leading to secondary infections such as Clostridium difficile colitis, and most concerning of all, apply selective pressure for emergence of multiresistant microbial strains, a major public health threat ( 5 ).…”

Section: Scope Of the Clinical Problemmentioning

confidence: 99%

Translating Lung Microbiome Profiles into the Next-Generation Diagnostic Gold Standard for Pneumonia: a Clinical Investigator’s Perspective

Kitsios

2018

mSystems

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Severe bacterial pneumonia is a major global cause of morbidity and mortality, yet current diagnostic approaches rely on identification of causative pathogens by cultures, which require extended incubation periods and often fail to detect relevant pathogens. Consequently, patients are prescribed broad-spectrum antibiotics in a “one-size-fits-all” manner, which may be inappropriate for their individual needs and promote antibiotic resistance.

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“… 6 Targeted respiratory physiotherapy treatments, including mucoactive agents, are used to manage secretion retention. 7 8 Mucoactive agents are a class of medications that aid the removal of mucus from the lung and are generally subclassified according to their mechanism of action. 9 Mucolytics, such as N-acetylcysteine (NAC), work by breaking mucin crosslinking, mucoregulators such as carbocisteine decrease mucus production, expectorants such as hypertonic saline (HTS) work by increasing water content, and mucokinetics such as ambroxol work by increasing pulmonary mucus transport by acting on the cilia.…”

Section: Introductionmentioning

confidence: 99%

Mucoactive agents for acute respiratory failure in the critically ill: a systematic review and meta-analysis

Anand

McAuley

Blackwood

et al. 2020

Thorax

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PurposeAcute respiratory failure (ARF) is a common cause of admission to intensive care units (ICUs). Mucoactive agents are medications that promote mucus clearance and are frequently administered in patients with ARF, despite a lack of evidence to underpin clinical decision making. The aim of this systematic review was to determine if the use of mucoactive agents in patients with ARF improves clinical outcomes.MethodsWe searched electronic and grey literature (January 2020). Two reviewers independently screened, selected, extracted data and quality assessed studies. We included trials of adults receiving ventilatory support for ARF and involving at least one mucoactive agent compared with placebo or standard care. Outcomes included duration of mechanical ventilation. Meta-analysis was undertaken using random-effects modelling and certainty of the evidence was assessed using Grades of Recommendation, Assessment, Development and Evaluation.ResultsThirteen randomised controlled trials were included (1712 patients), investigating four different mucoactive agents. Mucoactive agents showed no effect on duration of mechanical ventilation (seven trials, mean difference (MD) −1.34, 95% CI −2.97 to 0.29, I2=82%, very low certainty) or mortality, hospital stay and ventilator-free days. There was an effect on reducing ICU length of stay in the mucoactive agent groups (10 trials, MD −3.22, 95% CI −5.49 to −0.96, I2=89%, very low certainty).ConclusionOur findings do not support the use of mucoactive agents in critically ill patients with ARF. The existing evidence is of low quality. High-quality randomised controlled trials are needed to determine the role of specific mucoactive agents in critically ill patients with ARF.PROSPERO registration numberCRD42018095408.

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Prescribing Patterns of Drugs in Acute Respiratory Distress Syndrome (ARDS): An Observational Study

Cited by 5 publications

References 34 publications

Factors affecting the outcomes in patients with acute respiratory distress syndrome in a tertiary care setting

Factors affecting the outcomes in patients with acute respiratory distress syndrome in a tertiary care setting

Translating Lung Microbiome Profiles into the Next-Generation Diagnostic Gold Standard for Pneumonia: a Clinical Investigator’s Perspective

Mucoactive agents for acute respiratory failure in the critically ill: a systematic review and meta-analysis

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