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Critical Care
Published in: Critical Care 1/2020

Open Access 01-12-2020 | Antibiotic | Review

Update of the treatment of nosocomial pneumonia in the ICU

Authors: Rafael Zaragoza, Pablo Vidal-Cortés, Gerardo Aguilar, Marcio Borges, Emili Diaz, Ricard Ferrer, Emilio Maseda, Mercedes Nieto, Francisco Xavier Nuvials, Paula Ramirez, Alejandro Rodriguez, Cruz Soriano, Javier Veganzones, Ignacio Martín-Loeches

Published in: Critical Care | Issue 1/2020

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Abstract

In accordance with the recommendations of, amongst others, the Surviving Sepsis Campaign and the recently published European treatment guidelines for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), in the event of a patient with such infections, empirical antibiotic treatment must be appropriate and administered as early as possible. The aim of this manuscript is to update treatment protocols by reviewing recently published studies on the treatment of nosocomial pneumonia in the critically ill patients that require invasive respiratory support and patients with HAP from hospital wards that require invasive mechanical ventilation. An interdisciplinary group of experts, comprising specialists in anaesthesia and resuscitation and in intensive care medicine, updated the epidemiology and antimicrobial resistance and established clinical management priorities based on patients’ risk factors. Implementation of rapid diagnostic microbiological techniques available and the new antibiotics recently added to the therapeutic arsenal has been reviewed and updated. After analysis of the categories outlined, some recommendations were suggested, and an algorithm to update empirical and targeted treatment in critically ill patients has also been designed. These aspects are key to improve VAP outcomes because of the severity of patients and possible acquisition of multidrug-resistant organisms (MDROs).
Literature
1.
Levy MM, Evans LE, Rhodes A. The surviving sepsis campaign bundle: 2018 update. Intensive Care Med. 2018;44(6):925–8.PubMed
2.
Torres A, Niederman MS, Chastre J, Ewig S, Fernandez-Vandellos P, Hanberger H, et al. International ERS/ESICM/ESCMID/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia: guidelines for the management of hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP) of the European Respiratory Society (ERS), European Society of Intensive Care Medicine (ESICM), European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and Asociación Latinoamericana del Tórax (ALAT). Eur Respir J. 2017;50(3):1700582.
3.
4.
Montravers P, Bassetti M. The ideal patient profile for new beta-lactam/beta-lactamase inhibitors. Curr Opin Infect Dis. 2018;31(6):587–93.PubMed
5.
Bassetti M, Righi E, Vena A, Graziano E, Russo A, Peghin M. Risk stratification and treatment of ICU-acquired pneumonia caused by multidrug-resistant/extensively drug-resistant/pandrug-resistant bacteria. Curr Opin Crit Care. 2018;24(5):385–93.PubMed
6.
Rodríguez-Baño J, Paño-Pardo JR, Alvarez-Rocha L, Asensio A, Calbo E, Cercenado E, et al. Programs for optimizing the use of antibiotics (PROA) in Spanish hospitals: GEIH-SEIMC, SEFH and SEMPSPH consensus document. Enferm Infecc Microbiol Clin. 2012;30(1):22.e1–22.e23.
7.
Tabah A, Cotta MO, Garnacho-Montero J, Schouten J, Roberts JA, Lipman J, et al. A systematic review of the definitions, determinants, and clinical outcomes of antimicrobial de-escalation in the intensive care unit. Clin Infect Dis. 2016;62(8):1009–17.PubMed
8.
Ruiz J, Ramirez P, Gordon M, Villarreal E, Frasquet J, Poveda-Andres JL, et al. Antimicrobial stewardship programme in critical care medicine: a prospective interventional study. Med Int. 2018;42(5):266–73.
9.
10.
11.
Vincent J-L, Rello J, Marshall J, Silva E, Anzueto A, Martin CD, et al. International study of the prevalence and outcomes of infection in intensive care units. JAMA. 2009;302(21):2323–9.PubMed
12.
Magill SS, Edwards JR, Fridkin SK. Emerging infections program healthcare-associated infections and antimicrobial use prevalence survey team. Survey of health care-associated infections. N Engl J Med. 2014;370(26):2542–3.PubMed
13.
American Thoracic Society, Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med. 2005;171(4):388–416.
14.
Forel J-M, Voillet F, Pulina D, Gacouin A, Perrin G, Barrau K, et al. Ventilator-associated pneumonia and ICU mortality in severe ARDS patients ventilated according to a lung-protective strategy. Crit Care Lond Engl. 2012;16(2):R65.
15.
Asehnoune K, Seguin P, Allary J, Feuillet F, Lasocki S, Cook F, et al. Hydrocortisone and fludrocortisone for prevention of hospital-acquired pneumonia in patients with severe traumatic brain injury (Corti-TC): a double-blind, multicentre phase 3, randomised placebo-controlled trial. Lancet Respir Med. 2014;2(9):706–16.PubMed
16.
Bouglé A, Bombled C, Margetis D, Lebreton G, Vidal C, Coroir M, et al. Ventilator-associated pneumonia in patients assisted by veno-arterial extracorporeal membrane oxygenation support: epidemiology and risk factors of treatment failure. PLoS One. 2018;13(4):e0194976.PubMedPubMedCentral
17.
Dudeck MA, Weiner LM, Allen-Bridson K, Malpiedi PJ, Peterson KD, Pollock DA, et al. National Healthcare Safety Network (NHSN) report, data summary for 2012, device-associated module. Am J Infect Control. 2013;41(12):1148–66.PubMedPubMedCentral
18.
19.
20.
Álvarez-Lerma F, Palomar-Martínez M, Sánchez-García M, Martínez-Alonso M, Álvarez-Rodríguez J, Lorente L, et al. Prevention of ventilator-associated pneumonia: the multimodal approach of the Spanish ICU ‘Pneumonia Zero’ Program. Crit Care Med. 2018;46(2):181–8.PubMedPubMedCentral
21.
Martin-Loeches I, Povoa P, Rodríguez A, Curcio D, Suarez D, Mira J-P, et al. Incidence and prognosis of ventilator-associated tracheobronchitis (TAVeM): a multicentre, prospective, observational study. Lancet Respir Med. 2015;3(11):859–68.PubMed
22.
Nseir S, Povoa P, Salluh J, Rodriguez A, Martin-Loeches I. Is there a continuum between ventilator-associated tracheobronchitis and ventilator-associated pneumonia? Intensive Care Med. 2016;42(7):1190–2.PubMed
23.
Keane S, Martin-Loeches I. Host-pathogen interaction during mechanical ventilation: systemic or compartmentalized response? Crit Care Lond Engl. 2019;23(Suppl 1):134.
24.
Esperatti M, Ferrer M, Theessen A, Liapikou A, Valencia M, Saucedo LM, et al. Nosocomial pneumonia in the intensive care unit acquired by mechanically ventilated versus nonventilated patients. Am J Respir Crit Care Med. 2010;182(12):1533–9.PubMed
25.
Kohlenberg A, Schwab F, Behnke M, Geffers C, Gastmeier P. Pneumonia associated with invasive and noninvasive ventilation: an analysis of the German nosocomial infection surveillance system database. Intensive Care Med. 2010;36(6):971–8.PubMed
26.
Walter J, Haller S, Quinten C, Kärki T, Zacher B, Eckmanns T, et al. Healthcare-associated pneumonia in acute care hospitals in European Union/European Economic Area countries: an analysis of data from a point prevalence survey, 2011 to 2012. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull. 2018;23(32):1700843.
27.
Giuliano KK, Baker D, Quinn B. The epidemiology of nonventilator hospital-acquired pneumonia in the United States. Am J Infect Control. 2018;46(3):322–7.PubMed
28.
Sopena N, Sabrià M, Neunos 2000 Study Group. Multicenter study of hospital-acquired pneumonia in non-ICU patients. Chest. 2005;127(1):213–9.PubMed
29.
Koulenti D, Tsigou E, Rello J. Nosocomial pneumonia in 27 ICUs in Europe: perspectives from the EU-VAP/CAP study. Eur J Clin Microbiol Infect Dis. 2017;36(11):1999–2006.PubMed
30.
Ferrer M, Liapikou A, Valencia M, Esperatti M, Theessen A, Antonio Martinez J, et al. Validation of the American Thoracic Society-Infectious Diseases Society of America guidelines for hospital-acquired pneumonia in the intensive care unit. Clin Infect Dis. 2010;50(7):945–52.PubMed
31.
Restrepo MI, Peterson J, Fernandez JF, Qin Z, Fisher AC, Nicholson SC. Comparison of the bacterial etiology of early-onset and late-onset ventilator-associated pneumonia in subjects enrolled in 2 large clinical studies. Respir Care. 2013;58(7):1220–5.PubMedPubMedCentral
32.
Quartin AA, Scerpella EG, Puttagunta S, Kett DH. A comparison of microbiology and demographics among patients with healthcare-associated, hospital-acquired, and ventilator-associated pneumonia: a retrospective analysis of 1184 patients from a large, international study. BMC Infect Dis. 2013;13:561.PubMedPubMedCentral
33.
Nseir S, Martin-Loeches I, Makris D, Jaillette E, Karvouniaris M, Valles J, et al. Impact of appropriate antimicrobial treatment on transition from ventilator-associated tracheobronchitis to ventilator-associated pneumonia. Crit Care Lond Engl. 2014;18(3):R129.
34.
Pulido MR, Moreno-Martínez P, González-Galán V, Fernández Cuenca F, Pascual Á, Garnacho-Montero J, et al. Application of BioFire FilmArray Blood Culture Identification panel for rapid identification of the causative agents of ventilator-associated pneumonia. Clin Microbiol Infect. 2018;24(11):1213.e1–4.
35.
Huang Y, Jiao Y, Zhang J, Xu J, Cheng Q, Li Y, et al. Microbial etiology and prognostic factors of ventilator-associated pneumonia: a multicenter retrospective study in Shanghai. Clin Infect Dis. 2018;67(suppl_2):S146–52.PubMed
36.
Cantón-Bulnes ML, González-García MA, García-Sánchez M, Arenzana-Seisdedos Á, Garnacho-Montero J. A case-control study on the clinical impact of ventilator associated tracheobronchitis in adult patients who did not develop ventilator associated pneumonia. Enferm Infecc Microbiol Clin. 2019;37(1):31–5.PubMed
37.
Ibn Saied W, Mourvillier B, Cohen Y, Ruckly S, Reignier J, Marcotte G, et al. A comparison of the mortality risk associated with ventilator-acquired bacterial pneumonia and nonventilator ICU-acquired bacterial pneumonia. Crit Care Med. 2019;47(3):345–52.PubMed
38.
Micek ST, Chew B, Hampton N, Kollef MH. A case-control study assessing the impact of nonventilated hospital-acquired pneumonia on patient outcomes. Chest. 2016;150(5):1008–14.PubMedPubMedCentral
39.
Kollef MH, Shorr A, Tabak YP, Gupta V, Liu LZ, Johannes RS. Epidemiology and outcomes of health-care-associated pneumonia: results from a large US database of culture-positive pneumonia. Chest. 2005;128(6):3854–62.PubMed
40.
41.
Kollef MH, Hamilton CW, Ernst FR. Economic impact of ventilator-associated pneumonia in a large matched cohort. Infect Control Hosp Epidemiol. 2012;33(3):250–6.PubMed
42.
Micek ST, Wunderink RG, Kollef MH, Chen C, Rello J, Chastre J, et al. An international multicenter retrospective study of Pseudomonas aeruginosa nosocomial pneumonia: impact of multidrug resistance. Crit Care Lond Engl. 2015;19:219.
43.
Melsen WG, Rovers MM, Groenwold RHH, Bergmans DCJJ, Camus C, Bauer TT, et al. Attributable mortality of ventilator-associated pneumonia: a meta-analysis of individual patient data from randomised prevention studies. Lancet Infect Dis. 2013;13(8):665–71.PubMed
44.
Nseir S, Di Pompeo C, Pronnier P, Beague S, Onimus T, Saulnier F, et al. Nosocomial tracheobronchitis in mechanically ventilated patients: incidence, aetiology and outcome. Eur Respir J. 2002;20(6):1483–9.PubMed
45.
Hospital-acquired pneumonia in adults: diagnosis, assessment of severity, initial antimicrobial therapy, and preventive strategies. A consensus statement, American Thoracic Society, November 1995. Am J Respir Crit Care Med. 1996. 153(5):1711–25.
46.
Sopena N, Heras E, Casas I, Bechini J, Guasch I, Pedro-Botet ML, et al. Risk factors for hospital-acquired pneumonia outside the intensive care unit: a case-control study. Am J Infect Control. 2014;42(1):38–42.PubMed
47.
Di Pasquale M, Aliberti S, Mantero M, Bianchini S, Blasi F. Non-intensive care unit acquired pneumonia: a new clinical entity? Int J Mol Sci. 2016;17(3):287.PubMedPubMedCentral
48.
Herzig SJ, Howell MD, Ngo LH, Marcantonio ER. Acid-suppressive medication use and the risk for hospital-acquired pneumonia. JAMA. 2009;301(20):2120–8.PubMed
49.
Zhang Z, Duan J. Nosocomial pneumonia in non-invasive ventilation patients: incidence, characteristics, and outcomes. J Hosp Infect. 2015;91(2):153–7.PubMed
50.
Melsen WG, Rovers MM, Bonten MJM. Ventilator-associated pneumonia and mortality: a systematic review of observational studies. Crit Care Med. 2009;37(10):2709–18.PubMed
51.
Bekaert M, Timsit J-F, Vansteelandt S, Depuydt P, Vésin A, Garrouste-Orgeas M, et al. Attributable mortality of ventilator-associated pneumonia: a reappraisal using causal analysis. Am J Respir Crit Care Med. 2011;184(10):1133–9.PubMed
52.
Dupont H, Mentec H, Sollet JP, Bleichner G. Impact of appropriateness of initial antibiotic therapy on the outcome of ventilator-associated pneumonia. Intensive Care Med. 2001;27(2):355–62.PubMed
53.
Zilberberg MD, Shorr AF, Micek ST, Vazquez-Guillamet C, Kollef MH. Multi-drug resistance, inappropriate initial antibiotic therapy and mortality in Gram-negative severe sepsis and septic shock: a retrospective cohort study. Crit Care Lond Engl. 2014;18(6):596.
54.
Kollef MH. Treatment of ventilator-associated pneumonia: get it right from the start. Crit Care Med. 2003;31(3):969–70.PubMed
55.
Ranzani OT, Ferrer M, Esperatti M, Giunta V, Bassi GL, Carvalho CRR, et al. Association between systemic corticosteroids and outcomes of intensive care unit-acquired pneumonia. Crit Care Med. 2012;40(9):2552–61.PubMed
56.
Ceccato A, Panagiotarakou M, Ranzani OT, Martin-Fernandez M, Almansa-Mora R, Gabarrus A, et al. Lymphocytopenia as a predictor of mortality in patients with ICU-acquired pneumonia. J Clin Med 2019 13;8(6):843.
57.
Esperatti M, Ferrer M, Giunta V, Ranzani OT, Saucedo LM, Li Bassi G, et al. Validation of predictors of adverse outcomes in hospital-acquired pneumonia in the ICU. Crit Care Med. 2013;41(9):2151–61.PubMed
58.
Póvoa P, Martin-Loeches I, Ramirez P, Bos LD, Esperatti M, Silvestre J, et al. Biomarkers kinetics in the assessment of ventilator-associated pneumonia response to antibiotics - results from the BioVAP study. J Crit Care. 2017;41:91–7.PubMed
59.
Beardsley JR, Williamson JC, Johnson JW, Ohl CA, Karchmer TB, Bowton DL. Using local microbiologic data to develop institution-specific guidelines for the treatment of hospital-acquired pneumonia. Chest. 2006;130(3):787–93.PubMed
60.
Bonten MJ, Weinstein RA. The role of colonization in the pathogenesis of nosocomial infections. Infect Control Hosp Epidemiol. 1996;17(3):193–200.PubMed
61.
Torre-Cisneros J, Natera C, Mesa F, Trikic M, Rodríguez-Baño J. Clinical predictors of methicillin-resistant Staphylococcus aureus in nosocomial and healthcare-associated pneumonia: a multicenter, matched case-control study. Eur J Clin Microbiol Infect Dis. 2018;37(1):51–6.PubMed
62.
Torre-Cisneros J, Tejero García R, Natera Kindelán C, Font Ugalde P, Franco Álvarez de Luna F, Castón Osorio JJ, et al. Risk factors of nosocomial pneumonia caused by methicillin-resistant Staphylococcus aureus. Med Clin (Barc). 2012;138(3):99–106.
63.
Metersky ML, Frei CR, Mortensen EM. Predictors of Pseudomonas and methicillin-resistant Staphylococcus aureus in hospitalized patients with healthcare-associated pneumonia. Respirol Carlton Vic. 2016;21(1):157–63.
64.
Buhl M, Peter S, Willmann M. Prevalence and risk factors associated with colonization and infection of extensively drug-resistant Pseudomonas aeruginosa: a systematic review. Expert Rev Anti-Infect Ther. 2015;13(9):1159–70.PubMed
65.
Fernández-Barat L, Ferrer M, De Rosa F, Gabarrús A, Esperatti M, Terraneo S, et al. Intensive care unit-acquired pneumonia due to Pseudomonas aeruginosa with and without multidrug resistance. J Inf Secur. 2017;74(2):142–52.
66.
Rojo V, Vázquez P, Reyes S, Puente Fuertes L, Cervero M. Risk factors and clinical evolution of carbapenemase-producing Klebsiella pneumoniae infections in a university hospital in Spain. Case-control study. Rev Espanola Quimioter. 2018;31(5):427–34.
67.
Wang Z, Qin R-R, Huang L, Sun L-Y. Risk factors for carbapenem-resistant Klebsiella pneumoniae infection and mortality of Klebsiella pneumoniae infection. Chin Med J. 2018;131(1):56–62.PubMedPubMedCentral
68.
Gao B, Li X, Yang F, Chen W, Zhao Y, Bai G, et al. Molecular epidemiology and risk factors of ventilator-associated pneumonia infection caused by carbapenem-resistant Enterobacteriaceae. Front Pharmacol. 2019;10:262.PubMedPubMedCentral
69.
Sbrana F, Malacarne P, Bassetti M, Tascini C, Vegnuti L, Della Siega P, et al. Risk factors for ventilator associated pneumonia due to carbapenemase-producing Klebsiella pneumoniae in mechanically ventilated patients with tracheal and rectal colonization. Minerva Anestesiol. 2016;82(6):635–40.PubMed
70.
Peralta G, Sánchez MB, Garrido JC, De Benito I, Cano ME, Martínez-Martínez L, et al. Impact of antibiotic resistance and of adequate empirical antibiotic treatment in the prognosis of patients with Escherichia coli bacteraemia. J Antimicrob Chemother. 2007;60(4):855–63.PubMed
71.
Aydemir H, Tuz HI, Piskin N, Celebi G, Kulah C, Kokturk F. Risk factors and clinical responses of pneumonia patients with colistin-resistant Acinetobacter baumannii-calcoaceticus. World J Clin Cases. 2019;7(10):1111–21.PubMedPubMedCentral
72.
Zheng Y, Wan Y, Zhou L, Ye M, Liu S, Xu C, et al. Risk factors and mortality of patients with nosocomial carbapenem-resistant Acinetobacter baumannii pneumonia. Am J Infect Control. 2013;41(7):e59–63.PubMed
73.
Millot G, Voisin B, Loiez C, Wallet F, Nseir S. The next generation of rapid point-of-care testing identification tools for ventilator-associated pneumonia. Ann Transl Med. 2017;5(22):451.PubMedPubMedCentral
74.
Clavel M, Barraud O, Moucadel V, Meynier F, Karam E, Ploy M-C, et al. Molecular quantification of bacteria from respiratory samples in patients with suspected ventilator-associated pneumonia. Clin Microbiol Infect. 2016;22(9):812.e1–7.
75.
Teysseyre L, Ferdynus C, Miltgen G, Lair T, Aujoulat T, Lugagne N, et al. Derivation and validation of a simple score to predict the presence of bacteria requiring carbapenem treatment in ICU-acquired bloodstream infection and pneumonia: CarbaSCORE. Antimicrob Resist Infect Control. 2019;8:78.PubMedPubMedCentral
76.
Freire AT, Melnyk V, Kim MJ, Datsenko O, Dzyublik O, Glumcher F, et al. Comparison of tigecycline with imipenem/cilastatin for the treatment of hospital-acquired pneumonia. Diagn Microbiol Infect Dis. 2010;68(2):140–51.PubMed
77.
Rubinstein E, Lalani T, Corey GR, Kanafani ZA, Nannini EC, Rocha MG, et al. Telavancin versus vancomycin for hospital-acquired pneumonia due to gram-positive pathogens. Clin Infect Dis. 2011;52(1):31–40.PubMedPubMedCentral
78.
Kollef MH, Chastre J, Clavel M, Restrepo MI, Michiels B, Kaniga K, et al. A randomized trial of 7-day doripenem versus 10-day imipenem-cilastatin for ventilator-associated pneumonia. Crit Care Lond Engl. 2012;16(6):R218.
79.
Wunderink RG, Niederman MS, Kollef MH, Shorr AF, Kunkel MJ, Baruch A, et al. Linezolid in methicillin-resistant Staphylococcus aureus nosocomial pneumonia: a randomized, controlled study. Clin Infect Dis. 2012;54(5):621–9.PubMed
80.
Ramirez J, Dartois N, Gandjini H, Yan JL, Korth-Bradley J, McGovern PC. Randomized phase 2 trial to evaluate the clinical efficacy of two high-dosage tigecycline regimens versus imipenem-cilastatin for treatment of hospital-acquired pneumonia. Antimicrob Agents Chemother. 2013;57(4):1756–62.PubMedPubMedCentral
81.
Awad SS, Rodriguez AH, Chuang Y-C, Marjanek Z, Pareigis AJ, Reis G, et al. A phase 3 randomized double-blind comparison of ceftobiprole medocaril versus ceftazidime plus linezolid for the treatment of hospital-acquired pneumonia. Clin Infect Dis. 2014;59(1):51–61.PubMedPubMedCentral
82.
Torres A, Zhong N, Pachl J, Timsit J-F, Kollef M, Chen Z, et al. Ceftazidime-avibactam versus meropenem in nosocomial pneumonia, including ventilator-associated pneumonia (REPROVE): a randomised, double-blind, phase 3 non-inferiority trial. Lancet Infect Dis. 2018;18(3):285–95.PubMed
83.
Kollef MH, Nováček M, Kivistik Ü, Réa-Neto Á, Shime N, Martin-Loeches I, et al. Ceftolozane-tazobactam versus meropenem for treatment of nosocomial pneumonia (ASPECT-NP): a randomised, controlled, double-blind, phase 3, non-inferiority trial. Lancet Infect Dis. 2019;19(12):1299–311.
84.
Cisneros JM, Rosso-Fernández CM, Roca-Oporto C, De Pascale G, Jiménez-Jorge S, Fernández-Hinojosa E, et al. Colistin versus meropenem in the empirical treatment of ventilator-associated pneumonia (Magic Bullet study): an investigator-driven, open-label, randomized, noninferiority controlled trial. Crit Care Lond Engl. 2019;23(1):383.
85.
Bassetti M, Vena A, Russo A, Croxatto A, Calandra T, Guery B. Rational approach in the management of Pseudomonas aeruginosa infections. Curr Opin Infect Dis. 2018;31(6):578–86.PubMed
86.
Mensa J, Barberán J, Soriano A, Llinares P, Marco F, Cantón R, et al. Antibiotic selection in the treatment of acute invasive infections by Pseudomonas aeruginosa: guidelines by the Spanish Society of Chemotherapy. Rev Espanola Quimioter. 2018;31(1):78–100.
87.
Bassetti M, Righi E, Carnelutti A, Graziano E, Russo A. Multidrug-resistant Klebsiella pneumoniae: challenges for treatment, prevention and infection control. Expert Rev Anti-Infect Ther. 2018;16(10):749–61.PubMed
88.
Goodlet KJ, Nicolau DP, Nailor MD. In vitro comparison of ceftolozane-tazobactam to traditional beta-lactams and ceftolozane-tazobactam as an alternative to combination antimicrobial therapy for Pseudomonas aeruginosa. Antimicrob Agents Chemother. 2017;61(12):e01350–17.
89.
Tumbarello M, Trecarichi EM, Corona A, De Rosa FG, Bassetti M, Mussini C, et al. Efficacy of ceftazidime-avibactam salvage therapy in patients with infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae. Clin Infect Dis. 2019;68(3):355–64.PubMed
90.
Alraddadi BM, Saeedi M, Qutub M, Alshukairi A, Hassanien A, Wali G. Efficacy of ceftazidime-avibactam in the treatment of infections due to carbapenem-resistant Enterobacteriaceae. BMC Infect Dis. 2019;19(1):772.PubMedPubMedCentral
91.
Marshall S, Hujer AM, Rojas LJ, Papp-Wallace KM, Humphries RM, Spellberg B, et al. Can ceftazidime-avibactam and aztreonam overcome β-lactam resistance conferred by metallo-β-lactamases in Enterobacteriaceae? Antimicrob Agents Chemother. 2017;61(4):e02243–16.
92.
Harris PNA, Tambyah PA, Lye DC, Mo Y, Lee TH, Yilmaz M, et al. Effect of piperacillin-tazobactam vs meropenem on 30-day mortality for patients with E coli or Klebsiella pneumoniae bloodstream infection and ceftriaxone resistance: a randomized clinical trial. JAMA. 2018;320(10):984–94.PubMedPubMedCentral
93.
Wu JY, Srinivas P, Pogue JM. Cefiderocol: a novel agent for the management of multidrug-resistant Gram-negative organisms. Infect Dis Ther. 2020;9(1):17–40.
94.
Kollef MH, Ricard J-D, Roux D, Francois B, Ischaki E, Rozgonyi Z, et al. A randomized trial of the amikacin fosfomycin inhalation system for the adjunctive therapy of Gram-negative ventilator-associated pneumonia: IASIS Trial. Chest. 2017;151(6):1239–46.PubMed
95.
96.
Niederman MS. Adjunctive nebulized antibiotics: what is their place in ICU infections? Front Med. 2019;6:99.
97.
Bouglé A, Foucrier A, Dupont H, Montravers P, Ouattara A, Kalfon P, et al. Impact of the duration of antibiotics on clinical events in patients with Pseudomonas aeruginosa ventilator-associated pneumonia: study protocol for a randomized controlled study. Trials. 2017;18(1):37.PubMedPubMedCentral
Metadata
Title
Update of the treatment of nosocomial pneumonia in the ICU
Authors
Rafael Zaragoza
Pablo Vidal-Cortés
Gerardo Aguilar
Marcio Borges
Emili Diaz
Ricard Ferrer
Emilio Maseda
Mercedes Nieto
Francisco Xavier Nuvials
Paula Ramirez
Alejandro Rodriguez
Cruz Soriano
Javier Veganzones
Ignacio Martín-Loeches
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2020
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-020-03091-2

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