European perspective and update on the management of nosocomial pneumonia due to methicillin-resistant Staphylococcus aureus after more than 10 years of experience with linezolid

Autor: Francesco Blasi, Antoni Torres, Jean Chastre, Jordi Rello, Robert G. Masterton, Tobias Welte
Rok vydání: 2014
Předmět:
Methicillin-Resistant Staphylococcus aureus
Microbiology (medical)
medicine.medical_specialty
medicine.disease_cause
ventilator-associated pneumonia
chemistry.chemical_compound
Risk Factors
Vancomycin
Intensive care
Acetamides
Pneumonia
Staphylococcal
medicine
Animals
Humans
Intensive care medicine
Oxazolidinones
Antibacterial agent
Cross Infection
Clinical management
business.industry
Teicoplanin
nosocomial pneumonia
Ventilator-associated pneumonia
Linezolid
Pneumonia
Ventilator-Associated
General Medicine
biochemical phenomena
metabolism
and nutrition
medicine.disease
bacterial infections and mycoses
Methicillin-resistant Staphylococcus aureus
Anti-Bacterial Agents
Europe
Disease Models
Animal
Infectious Diseases
chemistry
Staphylococcus aureus
Practice Guidelines as Topic
business
medicine.drug
Zdroj: Clinical Microbiology and Infection. 20:19-36
ISSN: 1198-743X
DOI: 10.1111/1469-0691.12450
Popis: Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of antimicrobial-resistant hospital-acquired infections worldwide and remains a public health priority in Europe. Nosocomial pneumonia (NP) involving MRSA often affects patients in intensive care units with substantial morbidity, mortality and associated costs. A guideline-based approach to empirical treatment with an antibacterial agent active against MRSA can improve the outcome of patients with MRSA NP, including those with ventilator-associated pneumonia. New methods may allow more rapid or sensitive diagnosis of NP or microbiological confirmation in patients with MRSA NP, allowing early de-escalation of treatment once the pathogen is known. In Europe, available antibacterial agents for the treatment of MRSA NP include the glycopeptides (vancomycin and teicoplanin) and linezolid (available as an intravenous or oral treatment). Vancomycin has remained a standard of care in many European hospitals; however, there is evidence that it may be a suboptimal therapeutic option in critically ill patients with NP because of concerns about its limited intrapulmonary penetration, increased nephrotoxicity with higher doses, as well as the emergence of resistant strains that may result in increased clinical failure. Linezolid has demonstrated high penetration into the epithelial lining fluid of patients with ventilator-associated pneumonia and shown statistically superior clinical efficacy versus vancomycin in the treatment of MRSA NP in a phase IV, randomized, controlled study. This review focuses on the disease burden and clinical management of MRSA NP, and the use of linezolid after more than 10 years of clinical experience.
Databáze: OpenAIRE
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