Hospital-acquired pneumonia management

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... 

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. 

Management of Hospital-Acquired and Ventilator-Associated Pneumonia... 

Erythromycin may cause increases in the semm levels of simvastatin. The CSM has advised that this should not be co-prescribed with simvastatin. In the first instance the pharmacist should check local policies for management of hospital acquired chest infections/pneumonia to ascertain first and second line choices. If erythromycin or any macrolide cannot be avoided then a practical way forward may be to avoid taking any dose of simvastatin for the duration of the course of macrolide. In addition a recent Dmg Safety Update from the Medicines and Healthcare Products Regulatory Agency (MHRA, 2008) on statins has highlighted statin dmg interactions and the appropriate actions to take. 

Critical pathways, also known as clinical pathways or care maps, are tools of patient care management that are created by multidisciplinary teams, which are intended to lead to the most desirable patient outcome in the most desirable time frame. These programs prespecify what procedures, lab tests, medications, and dietary and exercise needs a patient should receive during a hospitalization for a specific time. There exists evidence that programs that focus on knee-replacement therapy and community-acquired pneumonia are... 

---