Management of ventilator-associated pneumonia: epidemiology, diagnosis and antimicrobial therapy
- 1 May 2012
- journal article
- review article
- Published by Taylor & Francis Ltd in Expert Review of Anti-infective Therapy
- Vol. 10 (5), 585-596
- https://doi.org/10.1586/eri.12.36
Abstract
Ventilator-associated pneumonia (VAP) is the most frequent infection among patients hospitalized in intensive care units, maintaining a high morbidity and mortality. The global incidence of VAP ranges from 8 to 28%. Early-onset VAP is mainly caused by community pathogens with a favorable pattern of antibiotic sensitivity, whereas late-onset VAP is often caused by multidrug-resistant pathogens, mainly methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa and Acinetobacter spp. and enteric Gram-negative bacilli. The diagnosis of VAP remains difficult to confirm, lacking both microbiological analysis and radiological signs of high specificity. The Clinical Infection Pulmonary Score has been proposed to overcome the difficulties related to the diagnosis, but is not applicable to all patient categories. A continuous evaluation of the antimicrobial therapeutic options, along with their pharmacodynamic and pharmacokinetic profiles, is mandatory to create therapeutic protocols and reduce VAP-related mortality.Keywords
This publication has 86 references indexed in Scilit:
- Meta-Analysis and Systematic Review of Procalcitonin-Guided Therapy in Respiratory Tract InfectionsAntimicrobial Agents and Chemotherapy, 2011
- Attributable Mortality of Ventilator-Associated PneumoniaAmerican Journal of Respiratory and Critical Care Medicine, 2011
- Early-onset ventilator-associated pneumonia incidence in intensive care units: a surveillance-based studyBMC Infectious Diseases, 2011
- Biomarkers for ventilator-associated pneumonia: Review of the literatureHeart & Lung, 2011
- Efficacy and safety of tigecycline: a systematic review and meta-analysisJournal of Antimicrobial Chemotherapy, 2011
- Telavancin versus Vancomycin for HospitalAcquired Pneumonia due to Gram-positive PathogensClinical Infectious Diseases, 2010
- Monte Carlo simulations: maximizing antibiotic pharmacokinetic data to optimize clinical practice for critically ill patientsJournal of Antimicrobial Chemotherapy, 2010
- Polyphyletic Emergence of Linezolid-Resistant Staphylococci in the United StatesAntimicrobial Agents and Chemotherapy, 2010
- Antibacterial-ResistantPseudomonas aeruginosa: Clinical Impact and Complex Regulation of Chromosomally Encoded Resistance MechanismsClinical Microbiology Reviews, 2009
- Clinical and Economic Impact of Common Multidrug-Resistant Gram-Negative BacilliAntimicrobial Agents and Chemotherapy, 2008