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Empiric Treatment in HAP/VAP: “Don’t You Want to Take a Leap of Faith?”

Ventilator-associated pneumonia is a frequent cause of ICU-acquired infections. These infections are associated with high morbidity and mortality. The increase in antibiotic resistance, particularly among Gram-negative bacilli, makes the choice of empiric antibiotic therapy complex for physicians. M...

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Autores principales: Chaïbi, Khalil, Péan de Ponfilly, Gauthier, Dortet, Laurent, Zahar, Jean-Ralph, Pilmis, Benoît
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8944836/
https://www.ncbi.nlm.nih.gov/pubmed/35326822
http://dx.doi.org/10.3390/antibiotics11030359
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author Chaïbi, Khalil
Péan de Ponfilly, Gauthier
Dortet, Laurent
Zahar, Jean-Ralph
Pilmis, Benoît
author_facet Chaïbi, Khalil
Péan de Ponfilly, Gauthier
Dortet, Laurent
Zahar, Jean-Ralph
Pilmis, Benoît
author_sort Chaïbi, Khalil
collection PubMed
description Ventilator-associated pneumonia is a frequent cause of ICU-acquired infections. These infections are associated with high morbidity and mortality. The increase in antibiotic resistance, particularly among Gram-negative bacilli, makes the choice of empiric antibiotic therapy complex for physicians. Multidrug-resistant organisms (MDROs) related infections are associated with a high risk of initial therapeutic inadequacy. It is, therefore, necessary to quickly identify the bacterial species involved and their susceptibility to antibiotics. New diagnostic tools have recently been commercialized to assist in the management of these infections. Moreover, the recent enrichment of the therapeutic arsenal effective on Gram-negative bacilli raises the question of their place in the therapeutic management of these infections. Most national and international guidelines recommend limiting their use to microbiologically documented infections. However, many clinical situations and, in particular, the knowledge of digestive or respiratory carriage by MDROs should lead to the discussion of the use of these new molecules, especially the new combinations with beta-lactamase inhibitors in empirical therapy. In this review, we present the current epidemiological data, particularly in terms of MDRO, as well as the clinical and microbiological elements that may be taken into account in the discussion of empirical antibiotic therapy for patients managed for ventilator-associated pneumonia.
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spelling pubmed-89448362022-03-25 Empiric Treatment in HAP/VAP: “Don’t You Want to Take a Leap of Faith?” Chaïbi, Khalil Péan de Ponfilly, Gauthier Dortet, Laurent Zahar, Jean-Ralph Pilmis, Benoît Antibiotics (Basel) Review Ventilator-associated pneumonia is a frequent cause of ICU-acquired infections. These infections are associated with high morbidity and mortality. The increase in antibiotic resistance, particularly among Gram-negative bacilli, makes the choice of empiric antibiotic therapy complex for physicians. Multidrug-resistant organisms (MDROs) related infections are associated with a high risk of initial therapeutic inadequacy. It is, therefore, necessary to quickly identify the bacterial species involved and their susceptibility to antibiotics. New diagnostic tools have recently been commercialized to assist in the management of these infections. Moreover, the recent enrichment of the therapeutic arsenal effective on Gram-negative bacilli raises the question of their place in the therapeutic management of these infections. Most national and international guidelines recommend limiting their use to microbiologically documented infections. However, many clinical situations and, in particular, the knowledge of digestive or respiratory carriage by MDROs should lead to the discussion of the use of these new molecules, especially the new combinations with beta-lactamase inhibitors in empirical therapy. In this review, we present the current epidemiological data, particularly in terms of MDRO, as well as the clinical and microbiological elements that may be taken into account in the discussion of empirical antibiotic therapy for patients managed for ventilator-associated pneumonia. MDPI 2022-03-08 /pmc/articles/PMC8944836/ /pubmed/35326822 http://dx.doi.org/10.3390/antibiotics11030359 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Chaïbi, Khalil
Péan de Ponfilly, Gauthier
Dortet, Laurent
Zahar, Jean-Ralph
Pilmis, Benoît
Empiric Treatment in HAP/VAP: “Don’t You Want to Take a Leap of Faith?”
title Empiric Treatment in HAP/VAP: “Don’t You Want to Take a Leap of Faith?”
title_full Empiric Treatment in HAP/VAP: “Don’t You Want to Take a Leap of Faith?”
title_fullStr Empiric Treatment in HAP/VAP: “Don’t You Want to Take a Leap of Faith?”
title_full_unstemmed Empiric Treatment in HAP/VAP: “Don’t You Want to Take a Leap of Faith?”
title_short Empiric Treatment in HAP/VAP: “Don’t You Want to Take a Leap of Faith?”
title_sort empiric treatment in hap/vap: “don’t you want to take a leap of faith?”
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8944836/
https://www.ncbi.nlm.nih.gov/pubmed/35326822
http://dx.doi.org/10.3390/antibiotics11030359
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