Evaluación de los pacientes con neumonía nosocomial y falta de respuesta al tratamiento

Translated title of the contribution: Assessment of patients with poor resolution of HAP

Richard G Wunderink*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Emphasis in VAP management is now shifting to the effectiveness of antibiotic therapy and its effect on subsequent mortality. As many as 62% of patients with VAP meet a set of objective criteria for failure to respond. The predominant microorganisms associated with failure of therapy are Pseudomonas aeruginosaand methicillin-resistant S. aureus(MRSA). Multiple causes of failure to respond in VAP exist: compromised host immunity, occult antibiotic resistance, inadequate antibiotic dosing, and concomitant or subsequent superinfections. The diagnosis of antibiotic failure and distinguishing failure from superinfection or noninfectious mimics is difficult because clinical criteria alone are inadequate. Microbiologic response is accurate only if quantitative cultures are used. Biochemical markers may be more accurate than clinical but still don't discriminate between causes. The appropriate diagnostic strategy and treatment algorithms have not been fully addressed and more research is clearly needed.

Translated title of the contributionAssessment of patients with poor resolution of HAP
Original languageSpanish
Pages (from-to)52-57
Number of pages6
JournalEnfermedades Infecciosas y Microbiologia Clinica
Volume23
Issue numberSUPPL.3
DOIs
StatePublished - Dec 5 2005

Keywords

  • Antibiotics
  • Pneumonia
  • Resistance

ASJC Scopus subject areas

  • Microbiology (medical)

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