Importance of appropriate initial antibiotic腹腔感染31.pdf

Eur Respir Rev 2007; 16: 103, 33–39 DOI: 10.118300010302 CopyrightERSJ Ltd 2007 Importance of appropriate initial antibiotic therapy and de-escalation in the treatment of nosocomial pneumonia J. Rello ABSTRACT: Inappropriate initial antibiotic therapy in nosocomial pneumonia is associated with CORRESPONDENCE higher mortality, longer hospital stays and increased healthcare costs. The key pathogens J. Rello Critical Care Dept associated with these adverse outcomes include Pseudomonas aeruginosa, methicillin-resistant Joan XXIII University Hospital and Staphylococcus aureus and Acinetobacter baumannii . CIBER Enfermedades Respiratorias Due to the increasing rates of resistance, a new paradigm is needed for treating nosocomial Carrer Mallafre Guasch 4 infections in the intensive care unit (ICU). Optimal initial therapy consists of a broad-spectrum 43007 Tarragona Spain antibiotic started in a timely manner and administered at the correct dose and via the correct route. Fax: 34 977295878 Because pathogen aetiology and resistance patterns vary from one ICU to another, E-mail: jrello.hj23.ics@gencat.net recommendations for initial