Nosocomial pneumonia with isolation of anaerobic bacteria in ICU patients: Therapeutic considerations and outcome
| Autor: | Pierre Doré, Ghislaine Grollier, Michel Hira, René Robertu]Ghislaine Grollier, Jean-Louis Fauchère, Edouard Ferrand |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Adult
Male medicine.medical_specialty Cefotaxime Adolescent medicine.drug_class Antibiotics Prevotella Ceftazidime Microbial Sensitivity Tests Drug resistance Critical Care and Intensive Care Medicine law.invention Bacteria Anaerobic Anti-Infective Agents Ciprofloxacin law Internal medicine Pneumonia Bacterial medicine Humans Intensive care medicine Aged Retrospective Studies Aged 80 and over Cross Infection business.industry Drug Resistance Microbial Middle Aged medicine.disease Intensive care unit Cephalosporins Pneumonia Treatment Outcome Female Anaerobic bacteria business medicine.drug |
| Zdroj: | Journal of Critical Care. 14:114-119 |
| ISSN: | 0883-9441 |
| DOI: | 10.1016/s0883-9441(99)90023-0 |
| Popis: | Purpose: Evaluate the influence of the anti-anaerobic antimicrobial therapy in the outcome of patients with nosocomial pneumonia. Materials and Methods: The population study included 53 intensive care unit patients with nosocomial pneumonia in whom, using a protected specimen brush, anaerobic bacteria were isolated, which were associated or not with aerobes. Current and empirical anti-biotherapies were retrospectively analyzed, regarding their efficacy against anaerobic bacteria. Since it was debated, sensitivity to cefotaxime, ceftazidime, and ciprofloxacin was determined in 38 strains of Prevotella species. Outcome was evaluated 10 days after the day of protected specimen brushes. Improvement was defined as a decrease of Murray score or ventilator weaning. Results: The most frequently isolated bacteria were Prevotella species, which were more frequently resistant to cefotaxime (37%), ceftazidime (50%), and ciprofloxacine (32%) than usually reported in the literature. Sixty-six percent of these strains produced β-lactamase. The effect of empirical anti-anaerobic antibiotherapy on the outcome at day 10 was evaluable in 39 patients. Twenty-nine patients were improved and 10 patients worsened. Interestingly, patients who had received well-adapted antibiotics against anaerobes had a better outcome after 10 days (P Conclusions: This study suggests that specific anti-anaerobic therapy may be considered in the choice of empirical antibiotherapy in patients with nosocomial pneumonia. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect