Hospital acquired pneumonia

May be preferred in patients whose risk of hospital-acquired pneumonia (HAP) is greater than upper gastrointestinal bleed. Data suggests a lower incidence of HAP when compared with H2-receptor antagonist... 

Unless risk factors for infection owing to potentially antibiotic-resistant bacteria ° Late-onset hospital-acquired pneumonia... 

Pneumonia is inflammation of the lung with consolidation. The cause of the inflammation is infection, which can result from a wide range of organisms. There are five classifications of pneumonia community-acquired, aspiration, hospital-acquired, ventilator-associated, and health care-associated. Patients who develop pneumonia in the outpatient setting and have not been in any health care facilities, which include wound care and hemodialysis clinics, have community-acquired pneumonia (CAP). Aspiration is of either oropharyngeal or gastrointestinal contents. Hospital-acquired pneumonia (HAP) is defined as pneumonia that occurs 48 hours or more after admission.1,2 Ventilator-associated pneumonia (VAP) requires endotracheal intubation for at least 48 to 72 hours before the onset of... 

Gram-negative aerobic bacilli and S. aureus are also the leading causative agents in hospital-acquired pneumonia. 

Levofloxacin (1), the levo-isomer or the (5)-enantiomer of ofloxacin, received FDA approval in 1996 (Fish, 2003 Hurst et al., 2002 Mascaretti, 2003 Norrby, 1999 North et al., 1998). The initial approval covered community-acquired pneumonia, acute bacterial exacerbation of chronic bronchitis, acute maxillary sinusitis, uncomplicated skin and skin structure infections, acute pyelonephritis, and complicated urinary tract infections (North et al., 1998). Four years later, the levofloxacin indication list grew to include community-acquired pneumonia caused by penicillin-resistant Streptococcus pneumoniae. In addition, in 2002, nosocomial (hospital-acquired) pneumonia caused by methicillin-susceptible Staphylococcus aureus, Pseudomonas aeruginosa, Serratia marcescens, Haemophilus influenzae, Kliebsella pneumoniae, and Escherichia coli was added (Hurst et al., 2002). Finally in 2004, LVX was approved as a post-exposure treatment for individuals exposed to Bacillus anthracis, the microbe that causes anthrax, via inhalation (FDA, 2004). 

Within the critical care environment, ciprofloxacin may form part of a regimen for hospital-acquired pneumonia and it has been recommended for anthrax prophylaxis. Care must be taken when coprescribing ciprofloxacin with warfarin or theophyllines as the... 

Anwendungs beobachtung bei 676 patienten. [Ciprofloxacin in the treatment of hospital-acquired pneumonia a surveillance study in 676 patients.] Pneumologie 2002 56(10) 599-604. 

It is licensed in the UK for Enterococcus faecium infections, skin and soft tissue infection, and in hospital-acquired pneumonia. 

The indications for line/olid arc for complicated and uncomplicated skin and soft-tissue infections, community- and hospital-acquired pneumonia, and drug-resistant Gram-positive infections. 

American Thoracic Society (ATS)—The ATS has issued guidelines for the treatment of community- and hospital-acquired pneumonia. These guidelines have also proven valuable as a reference point for clinicians want to establish treatment guidelines in their own institution. Although ATS guidelines carry considerable political influence, they are typically more consensus driven than evidence based in nature. 

Campbell GD, Niederman MS, Broughton WA, et al. Official ATS statement Hospital-acquired pneumonia in adults Diagnosis, assessment of severity, initial antimicrobial therapy and preventative strategies. Am J Respir Crit Care Med 1995 153 1711-1725. 

If she has a hospital-acquired pneumonia, coverage must be provided for coliforms, pneumococci, and anaerobes. In such a case, empiric treatment is likely to involve the parenteral administration of... 

Hospital-acquired pneumonia The patient developed postoperative pneumonia after a surgical procedure... 

Eggers, V. Fugener, K. Hein, O. V. Rommelspacher, H. Heyes, M. P. Kox, W. J. Spies, C. D. Antibiotic-mediated release of tumour neerosis factor alpha and norfaarman in patients with hospital-acquired pneumonia and septic encephalopathy. Intensive Care Med. 2004,30,1544—1551. 

Booth K, Parissis H. Teicoplanin-induced neutropenic sepsis rtiimickmg endocarditis. Asian Cardiovasc Thorac Ann2012 20(4) 460-2. Nannini EC, Corey GR, Stryjewski ME. Telavancin for the treatment of hospital-acquired pneumonia findings from the ATTAIN studies. Expert Rev Anti Infect Ther 2012 10(8) 847-54. 

The results of these studies demonstrate the need for early initiation of broad-spectrum empirical antimicrobial therapy on suspicion of VAP. The American Thoracic Society (ATS) published its first guidelines for the management of hospital-acquired pneumonia in 1995. In 1998, Trouillet et al. (15) suggested a different classification for the prediction of pathogens and the selection of antibiotic treatment based on the use or not of previous antibiotic use and the duration of MV. These classifications provide different rationale for the prediction of... 

Torres A, Aznar R, Gatell JM, et al. Incidence, risk, and prognosis factors of nosocomial pneumonia in mechanically ventilated patients. Am Rev Respir Dis 1990 142 523-528. Sopena N, Sabria M, and the Neumos Study Group. Multicenter study of hospital-acquired pneumonia in non-lCU patients. Chest 2005 127 213-219. 

Torres A, Ewig S. Diagnosing ventilator-associated pneumonia. N Engl J Med 2004 350 433 35. loanas M, Cavalcanti M, Eerrer M, et al. Hospital-acquired pneumonia coverage and treatment adequacy of current guidelines. Eur Respir J 2003 22 876-882. 

Niederman M, Craven D. Guidelines for the management of adults with hospital-acquired pneumonia, ventilator-associated pneumonia, and healthcare-associated pneumonia. Am J Respir Crit Care Med 2005 171 388 16. 

Leu HS, Kaiser DL, Mori M, Woolson RF, Wenzel RP. Hospital-acquired pneumonia. Attributable mortality and morbidity. Am J Epidemiol 1989 129 1258-1267. 

Wenzel RP. Hospital acquired pneumonia overview of the current state of the art of prevention and control. Eur J Clin Microbiol Infect Dis 1989 8 56-60. 

Craven DE, Steger KA, Fleming CA. Preventing hospital-acquired pneumonia current concepts and strategies. Semin Respir Crit Care Med 1997 18 185-200. 

Kirton OC, DeHaven B, Morgan J, Morejon O, Civetta J. A prospective, randomized comparison of an in-line heat moisture exchange filter and heated wire humidifiers Rates of ventilator associated early-onset (community-acquired) or late-onset (hospital-acquired) pneumonia and incidence of endotracheal tube occlusion. Chest. In Press. 

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