Epidemiologie, Diagnostik und Therapie erwachsener Patienten mit nosokomialer Pneumonie

Autor: Sören Gatermann, H. von Baum, Gernot Rohde, J. Lorenz, B. Schaaf, H. Gerlach, Reiner Schaumann, Petra Gastmeier, B. Grabein, Simone Rosseau, M. Abele-Horn, Klaus Dalhoff, Tobias Welte, Stefan Andreas, Claudia Spies, Maria Deja, Irit Nachtigall, Konstantin Mayer, E. Kramme, D. Schreiter, Winfried V. Kern, Helmut Sitter, Torsten T. Bauer, Harald Seifert, Santiago Ewig, Mathias W. Pletz, Gert Höffken, Hartwig Schütte, Christoph Lange
Rok vydání: 2012
Předmět:
Zdroj: Pneumologie. 66:707-765
ISSN: 1438-8790
0934-8387
DOI: 10.1055/s-0032-1325924
Popis: Nosocomial pneumonia (HAP) is a frequent complication of hospital care. Most data are available on ventilator-associated pneumonia. However infections on general wards are also increasing. A central issue are infections with multi drug resistant (MDR) pathogens which are difficult to treat particularly in the empirical setting potentially leading to inappropriate use of antimicrobial therapy. This guideline was compiled by an interdisciplinary group on the basis of a systematic literature review. Recommendations are made according to GRADE giving guidance for the diagnosis and therapy of HAP on the basis of quality of evidence and benefit/risk ratio. The guideline has two parts. First an update on epidemiology, spectrum of pathogens and antiinfectives is provided. In the second part recommendations for the management of diagnosis and treatment are given. Proper microbiologic work up is emphasized for knowledge of the local patterns of microbiology and drug susceptibility. Moreover this is the optimal basis for deescalation in the individual patient. The intensity of antimicrobial therapy is guided by the risk of infections with MDR. Structured deescalation concepts and strict limitation of treatment duration should lead to reduced selection pressure.
Databáze: OpenAIRE
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