Hospital-Acquired Pneumonia: Etiology and Antimicrobial Therapy

Hospital-Acquired Pneumonia: Etiology and Antimicrobial Therapy

Author Medeiros, Eduardo Alexandrino Servolo Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Hospital-acquired pneumonia (HAP) is a common and severe complication of critically ill patients. It has been associated with increased length of stay in the hospital and intensive care unit, as well as to high mortality rates. The potentially causative HAP pathogens can be suspected based on the assessment of a variety of risk factors, including the severity of the pneumonia itself, the presence of risk factors for specific organisms, length of hospital stay and prior antimicrobial use. The selection of empirical antimicrobial treatment of HAP has been challenged by the emergence and spread of multidrug-resistant organisms. Initial antimicrobial therapy should be guided against the most frequent HAP etiologic agents taking into the consideration the local frequency and susceptibility patterns exhibited by the most prevalent pathogens. Early and appropriate broad-spectrum antibiotic therapy should be prescribed with adequate doses to optimize antimicrobial efficacy. De-escalation of the antimicrobial regimen should be made as soon as the culture and susceptibility results become available. Efforts should also be made in limiting the time of antibiotic therapy.
Keywords Hospital-acquired pneumonia
ventilator associated pneumonia
antimicrobial resistance
antimicrobial therapy
Language English
Date 2008-10-01
Published in Brazilian Journal Of Infectious Diseases. Salvador: Contexto, v. 12, p. 29-38, 2008.
ISSN 1413-8670 (Sherpa/Romeo, impact factor)
Publisher Contexto
Extent 29-38
Access rights Closed access
Type Article
Web of Science ID WOS:000266634000005
URI http://repositorio.unifesp.br/11600/42883

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