Management of nosocomial pneumonia—state of the art

T Welte

doi:10.1007/s00390-006-0721-2

. 2006;43(4):301–309. [Article in German] doi: 10.1007/s00390-006-0721-2

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Management of nosocomial pneumonia—state of the art

T Welte ^1,^✉

PMCID: PMC7101873 PMID: 32287633

Summary

Nosocomial pneumonia is among the most frequent infections in the intensive care unit with high morbidity and mortality. The decisive factor for treatment failure is inadequate previous antibiotic treatment. Broad spectrum and sufficiently high dosed initial treatment is crucial.

To prevent further resistances, the antibiotic treatment must be evaluated early. Depending on the treatment success, treatment has to be changed or terminated. Deescalation is possible and sensible after three days. A treatment period of seven days should not routinely be exceeded. The treatment recommendations should be adapted to local resistances and the local statistics of frequent pathogens. A further factor for treatment decision-making is the risk analysis of the patient (previous treatment, stays in hospitals or nursing homes, concomitant diseases).

Key words: Nosocomial pneumonia, diagnosis, therapy, antibiotics

Literatur

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[CR1] 1.Vincent JAMA. 1995;274:639. doi: 10.1001/jama.274.8.639. [DOI] [PubMed] [Google Scholar]

[CR2] 2.Alberti Am J Respir Crit Care Med. 2005;171:461. doi: 10.1164/rccm.200403-324OC. [DOI] [PubMed] [Google Scholar]

[CR3] 3.Garnacho-Montero Crit Care. 2003;Med:2742. [Google Scholar]

[CR4] 4.Dietrich Infection. 2002;30:61. doi: 10.1007/s15010-002-1083-8. [DOI] [PubMed] [Google Scholar]

[CR5] 5.Cosgrove Clin Infect Dis. 2006;42:S82. doi: 10.1086/499406. [DOI] [PubMed] [Google Scholar]

[CR6] 6.Pletz MW, Welte T (2005) Pneumonie. In: Dietel M, Suttorp N, Zeitz M (Hrsg) Harrison’s Innere Medizin (dt. Ausgabe), ABW Wissenschaftsverlag GmbH, Berlin, S 1638–1650

[CR7] 7.Gastmeier Infection. 2005;33:50. doi: 10.1007/s15010-005-3186-5. [DOI] [PubMed] [Google Scholar]

[CR8] 8.Martin N Engl J Med. 2003;348:1546. doi: 10.1056/NEJMoa022139. [DOI] [PubMed] [Google Scholar]

[CR9] 9.el-Ebiary Am J Respir Crit Care Med. 1997;156:583. doi: 10.1164/ajrccm.156.2.9612023. [DOI] [PubMed] [Google Scholar]

[CR10] 10.Meersseman Am J Respir Crit Care Med. 2004;170:621. doi: 10.1164/rccm.200401-093OC. [DOI] [PubMed] [Google Scholar]

[CR11] 11.National Am J Infect Control. 2004;32:470. doi: 10.1016/j.ajic.2004.10.001. [DOI] [Google Scholar]

[CR12] 12.Huotari Eur J Clin Microbiol Infect Dis. 2003;22:492. doi: 10.1007/s10096-003-0975-6. [DOI] [PubMed] [Google Scholar]

[CR13] 13.Hong Clin Infect Dis. 2005;40:e84. doi: 10.1086/429822. [DOI] [PubMed] [Google Scholar]

[CR14] 14.Neuhauser JAMA. 2003;289:885. doi: 10.1001/jama.289.7.885. [DOI] [PubMed] [Google Scholar]

[CR15] 15.Grundmann Crit Care Med. 2005;33:946. doi: 10.1097/01.CCM.0000163223.26234.56. [DOI] [PubMed] [Google Scholar]

[CR16] 16.Goossens Lancet. 2005;365:579. doi: 10.1016/S0140-6736(05)17907-0. [DOI] [PubMed] [Google Scholar]

[CR17] 17.Welte Eur Respir Mon. 2004;28:165. [Google Scholar]

[CR18] 18.Pletz Antimicrob Agents Chemother. 2006;50:943. doi: 10.1128/AAC.50.3.943-948.2006. [DOI] [PMC free article] [PubMed] [Google Scholar]

[CR19] 19.Namias J Trauma. 2000;49:638. doi: 10.1097/00005373-200010000-00010. [DOI] [PubMed] [Google Scholar]

[CR20] 20.Metlay Arch Intern Med. 1997;157:1453. doi: 10.1001/archinte.157.13.1453. [DOI] [PubMed] [Google Scholar]

[CR21] 21.Hopstaken Fam Pract. 2006;23:180. doi: 10.1093/fampra/cmi100. [DOI] [PubMed] [Google Scholar]

[CR22] 22.Pugin Am Rev Respir Dis. 1991;143:1121. doi: 10.1164/ajrccm/143.5_Pt_1.1121. [DOI] [PubMed] [Google Scholar]

[CR23] 23.Kollef Chest. 1997;112:765. doi: 10.1378/chest.112.3.765. [DOI] [PubMed] [Google Scholar]

[CR24] 24.Christ-Crain Lancet. 2004;363:600. doi: 10.1016/S0140-6736(04)15591-8. [DOI] [PubMed] [Google Scholar]

[CR25] 25.Ewig Thorax. 2004;59:421. doi: 10.1136/thx.2003.008110. [DOI] [PMC free article] [PubMed] [Google Scholar]

[CR26] 26.Fagon Ann Intern Med. 2000;132:621. doi: 10.7326/0003-4819-132-8-200004180-00004. [DOI] [PubMed] [Google Scholar]

[CR27] 27.Ruiz Am J Respir Crit Care Med. 2000;162:119. doi: 10.1164/ajrccm.162.1.9907090. [DOI] [PubMed] [Google Scholar]

[CR28] 28.Maskell Chest. 2004;126:2022. doi: 10.1378/chest.126.6.2022. [DOI] [PubMed] [Google Scholar]

[CR29] 29.Hoffken Pneumologie. 2005;59:612. doi: 10.1055/s-2005-870988. [DOI] [PubMed] [Google Scholar]

[CR30] 30.Tablan MMWR Recomm Rep. 2004;53:1. [PubMed] [Google Scholar]

[CR31] 31.Valles Chest. 2003;123:1615. doi: 10.1378/chest.123.5.1615. [DOI] [PubMed] [Google Scholar]

[CR32] 32.Luna Chest. 1997;111:676. doi: 10.1378/chest.111.3.676. [DOI] [PubMed] [Google Scholar]

[CR33] 33.Trouillet Am J Respir Crit Care Med. 1998;157:531. doi: 10.1164/ajrccm.157.2.9705064. [DOI] [PubMed] [Google Scholar]

[CR34] 34.American Am J Respir Crit Care Med. 2005;171:388. doi: 10.1164/rccm.200405-644ST. [DOI] [PubMed] [Google Scholar]

[CR35] 35.Sandiumenge Intensive Care Med. 2003;29:876. doi: 10.1007/s00134-003-1715-1. [DOI] [PubMed] [Google Scholar]

[CR36] 36.Singh Am J Respir Crit Care Med. 2000;162:505. doi: 10.1164/ajrccm.162.2.9909095. [DOI] [PubMed] [Google Scholar]

[CR37] 37.Chastre JAMA. 2003;290:2588. doi: 10.1001/jama.290.19.2588. [DOI] [PubMed] [Google Scholar]

[CR38] 38.Dunbar Curr Med Res Opin. 2004;20:555. doi: 10.1185/030079904125003304. [DOI] [PubMed] [Google Scholar]

[CR39] 39.Halm N Engl J Med. 2002;347:2039. doi: 10.1056/NEJMcp020499. [DOI] [PubMed] [Google Scholar]

[CR40] 40.Arancibia Arch Intern Med. 2002;162:1849. doi: 10.1001/archinte.162.16.1849. [DOI] [PubMed] [Google Scholar]

[CR41] 41.Giantsou Intensive Care Med. 2005;31:1488. doi: 10.1007/s00134-005-2697-y. [DOI] [PubMed] [Google Scholar]

[CR42] 42.Paul BMJ. 2004;328:668. doi: 10.1136/bmj.38028.520995.63. [DOI] [PMC free article] [PubMed] [Google Scholar]

[CR43] 43.Safdar Lancet Infect Dis. 2004;4:519. doi: 10.1016/S1473-3099(04)01108-9. [DOI] [PubMed] [Google Scholar]

[CR44] 44.Hoffman Nature. 2005;436:1171. doi: 10.1038/nature03912. [DOI] [PubMed] [Google Scholar]

[CR45] 45.Chamot Antimicrob Agents Chemother. 2003;47:2756. doi: 10.1128/AAC.47.9.2756-2764.2003. [DOI] [PMC free article] [PubMed] [Google Scholar]

[CR46] 46.Mayer J Antimicrob Chemother. 1999;43:651. doi: 10.1093/jac/43.5.651. [DOI] [PubMed] [Google Scholar]

[CR47] 47.Burkhardt Med Monatsschr Pharm. 2006;29:56. [PubMed] [Google Scholar]

[CR48] 48.Rello Crit Care Med. 2005;33:1983. doi: 10.1097/01.CCM.0000178180.61305.1D. [DOI] [PubMed] [Google Scholar]

[CR49] 49.Welte T (2006) Arzneimittelkommission der deutschen Ärzteschaft (Hrsg) Arzneiverordnungen. Deutscher Ärzte-Verlag, Köln, S 879–891

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Die nosokomiale Pneumonie

Management of nosocomial pneumonia—state of the art

T Welte

Zusammenfassung

Summary

Literatur

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PERMALINK

Die nosokomiale Pneumonie

Management of nosocomial pneumonia—state of the art

T Welte

Zusammenfassung

Summary

Literatur

ACTIONS

PERMALINK

RESOURCES

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