Should antibiotic combinations be used to treat ventilator-associated pneumonia?

Détails

ID Serval
serval:BIB_12046C49DCC7
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Should antibiotic combinations be used to treat ventilator-associated pneumonia?
Périodique
Seminars in Respiratory and Critical Care Medicine
Auteur⸱e⸱s
Eggimann P., Revelly J.P.
ISSN
1069-3424
Statut éditorial
Publié
Date de publication
02/2006
Peer-reviewed
Oui
Volume
27
Numéro
1
Pages
68-81
Langue
anglais
Notes
Publication types: Journal Article ; Review
Résumé
This review summarizes the rationale for using or not using combinations of antibiotics to treat ventilator-associated pneumonia (VAP). Patients suffering from VAP require empirical antibiotic treatment before the identification of an etiologic agent. Most treatment failures are related to inappropriate initial antibiotic treatment with insufficient coverage of multidrug-resistant (MDR) pathogens. Guidelines require initial (empirical) treatment of VAP with a combination of antibiotics. However, this contributes to overexposure to antibiotics and further emergence of MDR microorganisms. We review the rationale for using combinations of antibiotics to cover MDR gram-negatives. However, clinical data supporting this strategy are limited. In fact, systematic combination therapy may have contributed to the overuse of antibiotics and to the emergence of MDR microorganisms. Nevertheless, combination therapy is our best strategy to treat severe infections due to suspected MDR microorganisms. Optimally, therapeutic strategies should be sufficiently broad to cover relevant pathogens while minimizing the risk for emergence of antimicrobial resistance.
Mots-clé
Anti-Bacterial Agents/therapeutic use, Drug Resistance, Bacterial, Drug Therapy, Combination, Humans, Pneumonia, Bacterial/drug therapy, Pneumonia, Bacterial/epidemiology, Practice Guidelines as Topic, Pseudomonas Infections/drug therapy, Pseudomonas aeruginosa, Ventilators, Mechanical/adverse effects
Pubmed
Web of science
Création de la notice
24/01/2008 17:04
Dernière modification de la notice
20/08/2019 12:39
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