Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia.

@article{2005GuidelinesFT,
  title={Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia.},
  author={良輔 古谷 and 和将 山口},
  journal={American journal of respiratory and critical care medicine},
  year={2005},
  volume={171 4},
  pages={
          388-416
        }
}
Executive Summary Introduction Methodology Used to Prepare the Guideline Epidemiology Incidence Etiology Major Epidemiologic Points Pathogenesis Major Points for Pathogenesis Modifiable Risk Factors Intubation and Mechanical Ventilation Aspiration, Body Position, and Enteral Feeding Modulation of Colonization: Oral Antiseptics and Antibiotics Stress Bleeding Prophylaxis, Transfusion, and Glucose Control Major Points and Recommendations for Modifiable Risk Factors Diagnostic Testing Major Points… Expand

Paper Mentions

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ConditionsAntibiotic Resistant Infection, Critical Illness
InterventionDrug
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ConditionsPneumonia
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ConditionsSepsis, Ventilator Associated Pneumonia ( VAP)
InterventionDietary Supplement
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Patients with clinically suspected VAP who receive initial empiric therapy with antipseudomonal penicillins plus beta-lactamase inhibitors, and possibly aminoglycosides, have lower in-hospital mortality rates when compared with those who are not treated with these antibiotics. Expand
Clinical importance of delays in the initiation of appropriate antibiotic treatment for ventilator-associated pneumonia.
TLDR
Clinicians should avoid delaying the administration of appropriate antibiotic treatment to patients with VAP in order to minimize their risk of mortality. Expand
Diagnosis and treatment of ventilator-associated pneumonia--impact on survival. A decision analysis.
TLDR
Invasive or semi-invasive diagnostic techniques should be used to diagnose VAP, guide therapy, and thereby potentially improve survival and a prospective, randomized trial assessing outcome according to diagnostic technique is needed. Expand
Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial.
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Although patients with VAP caused by nonfermenting gram-negative bacilli, including Pseudomonas aeruginosa, did not have more unfavorable outcomes when antimicrobial therapy lasted only 8 days, they did have a higher pulmonary infection-recurrence rate compared with those receiving 15 days of treatment. Expand
Experience with a clinical guideline for the treatment of ventilator-associated pneumonia
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The application of a clinical guideline for the treatment of ventilator-associated pneumonia can increase the initial administration of adequate antimicrobial treatment and decrease the overall duration of antibiotic treatment. Expand
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To test the hypothesis that an invasive management strategy is superior to a clinical, noninvasive one in terms of improving clinical outcomes and minimizing antibiotic use, a multicenter, randomized, uncontrolled trial is initiated to compare these strategies in patients suspected of having ventilator-associated pneumonia. Expand
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TLDR
Clinicians can improve antimicrobial treatment by using empirical combination antibiotic therapy based on individual patient characteristics and the predominant bacterial flora and their antibiotic susceptibility profiles, and this broad-spectrum therapy can be narrowed when initial culture results are received. Expand
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TLDR
The prescription of empirical antimicrobial Therapy by a senior physician in agreement with practice guidelines made it possible to achieve a crude rate of 89% of adequate antimicrobial therapy in study patients, which was associated with a 39% excess of mortality. Expand
Short-course empiric antibiotic therapy for patients with pulmonary infiltrates in the intensive care unit. A proposed solution for indiscriminate antibiotic prescription.
TLDR
The operational criteria used, regardless of the precise definition of pneumonia, accurately identified patients with pulmonary infiltrates for whom monotherapy with a short course of antibiotics was appropriate, and led to significantly lower antimicrobial therapy costs, antimicrobial resistance, and superinfections without adversely affecting the length of stay or mortality. Expand
The influence of mini-BAL cultures on patient outcomes: implications for the antibiotic management of ventilator-associated pneumonia.
TLDR
It is suggested that antibiotic selection prior to obtaining the results of lower airway cultures is an important determinant of outcome for patients with suspected VAP, and a delay in initiating adequate antibiotic therapy was associated with a greater mortality. Expand
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