Current and Future Considerations for the Treatment of Hospital-Acquired Pneumonia
Identifieur interne : 000075 ( Main/Exploration ); précédent : 000074; suivant : 000076Current and Future Considerations for the Treatment of Hospital-Acquired Pneumonia
Auteurs : Philippe Montravers [France] ; Adela Harpan [France] ; Elise Guivarch [France]Source :
- Advances in Therapy [ 0741-238X ] ; 2016.
Abstract
Hospital-acquired pneumonia (HAP) and health-care-associated pneumonia (HCAP) are leading causes of death, morbidity, and resource utilization in hospitalized patients, and are associated with a broad range of Gram-positive and Gram-negative pathogens. Here, we discuss the different definitions of HAP and HCAP, review current guidelines regarding the treatment of these conditions, highlight the shortcomings of current therapeutic options, and discuss new antibiotic treatments. To optimize therapeutic outcomes in patients with HAP/HCAP, initial antimicrobial treatment must be appropriate and should be given as soon as possible; inappropriate or delayed therapy greatly increases morbidity and mortality. Selection of the most appropriate antimicrobial agent depends on the causative pathogen(s); initial broad-spectrum therapy is commonly recommended and should cover all pathogens that may be present. Treatment selection should also take into consideration the following factors: knowledge of underlying local risk factors for antimicrobial resistance, disease staging, and risk factors related to specific pathogens such as
Basilea Pharmaceutica Ltd., Basel, Switzerland.
The online version of this article (doi:10.1007/s12325-016-0293-x) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1007/s12325-016-0293-x
PubMed: 26861846
PubMed Central: 4769724
Affiliations:
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nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">University Denis Diderot, PRESS Sorbonne Cité, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>University Denis Diderot, PRESS Sorbonne Cité, Paris</wicri:regionArea><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author></analytic><series><title level="j">Advances in Therapy</title><idno type="ISSN">0741-238X</idno><idno type="eISSN">1865-8652</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Abstract</title><p>Hospital-acquired pneumonia (HAP) and health-care-associated pneumonia (HCAP) are leading causes of death, morbidity, and resource utilization in hospitalized patients, and are associated with a broad range of Gram-positive and Gram-negative pathogens. Here, we discuss the different definitions of HAP and HCAP, review current guidelines regarding the treatment of these conditions, highlight the shortcomings of current therapeutic options, and discuss new antibiotic treatments. To optimize therapeutic outcomes in patients with HAP/HCAP, initial antimicrobial treatment must be appropriate and should be given as soon as possible; inappropriate or delayed therapy greatly increases morbidity and mortality. Selection of the most appropriate antimicrobial agent depends on the causative pathogen(s); initial broad-spectrum therapy is commonly recommended and should cover all pathogens that may be present. Treatment selection should also take into consideration the following factors: knowledge of underlying local risk factors for antimicrobial resistance, disease staging, and risk factors related to specific pathogens such as <italic>Pseudomonas aeruginosa</italic>, <italic>Acinetobacter</italic> spp., and methicillin-resistant <italic>Staphylococcus aureus</italic> (MRSA). Guidelines consistently emphasize the importance of treating HAP and HCAP with early and appropriate broad-spectrum antibiotics, and recent developments in this field have resulted in the availability of several additional treatment options. Telavancin shows potent activity against Gram-positive bacteria including MRSA and can be administered once daily; it was approved in the USA and European Union for the treatment of HAP after demonstrating non-inferiority to vancomycin. Ceftobiprole medocaril exhibits rapid antimicrobial activity against a broad range of both Gram-positive and Gram-negative pathogens, including MRSA. It was approved for the treatment of HAP (excluding ventilator-associated pneumonia) and community-acquired pneumonia in Europe in 2013. These new treatments may offer effective alternative therapeutic options for the management of HAP.</p></sec><sec><title>Funding</title><p>Basilea Pharmaceutica Ltd., Basel, Switzerland.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1007/s12325-016-0293-x) contains supplementary material, which is available to authorized users.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Chawla, R" uniqKey="Chawla R">R Chawla</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Montravers, P" uniqKey="Montravers P">P Montravers</name></author><author><name sortKey="Veber, B" uniqKey="Veber B">B Veber</name></author><author><name sortKey="Auboyer, C" uniqKey="Auboyer C">C Auboyer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kollef, Mh" uniqKey="Kollef M">MH 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Sader</name></author><author><name sortKey="Jones, Rn" uniqKey="Jones R">RN Jones</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bustos, C" uniqKey="Bustos C">C Bustos</name></author><author><name sortKey="Del Pozo, Jl" uniqKey="Del Pozo J">JL Del Pozo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Awad, Ss" uniqKey="Awad S">SS Awad</name></author><author><name sortKey="Rodriguez, Ah" uniqKey="Rodriguez A">AH Rodriguez</name></author><author><name sortKey="Chuang, Yc" uniqKey="Chuang Y">YC Chuang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Holmes, Ne" uniqKey="Holmes N">NE Holmes</name></author><author><name sortKey="Tong, Sy" uniqKey="Tong S">SY Tong</name></author><author><name sortKey="Davis, Js" uniqKey="Davis J">JS Davis</name></author><author><name sortKey="Hal, Sj" uniqKey="Hal S">SJ Hal</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nicholson, Sc" uniqKey="Nicholson S">SC Nicholson</name></author><author><name sortKey="Welte, T" uniqKey="Welte T">T Welte</name></author><author><name sortKey="File, Tm" uniqKey="File T">TM File</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Locke, Jb" uniqKey="Locke J">JB Locke</name></author><author><name sortKey="Zurenko, Ge" uniqKey="Zurenko G">GE Zurenko</name></author><author><name sortKey="Shaw, Kj" uniqKey="Shaw K">KJ Shaw</name></author><author><name sortKey="Bartizal, K" uniqKey="Bartizal K">K Bartizal</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>France</li></country><region><li>Île-de-France</li></region><settlement><li>Paris</li></settlement></list><tree><country name="France"><region name="Île-de-France"><name sortKey="Montravers, Philippe" sort="Montravers, Philippe" uniqKey="Montravers P" first="Philippe" last="Montravers">Philippe Montravers</name></region><name sortKey="Guivarch, Elise" sort="Guivarch, Elise" uniqKey="Guivarch E" first="Elise" last="Guivarch">Elise Guivarch</name><name sortKey="Guivarch, Elise" sort="Guivarch, Elise" uniqKey="Guivarch E" first="Elise" last="Guivarch">Elise Guivarch</name><name sortKey="Harpan, Adela" sort="Harpan, Adela" uniqKey="Harpan A" first="Adela" last="Harpan">Adela Harpan</name><name sortKey="Montravers, Philippe" sort="Montravers, Philippe" uniqKey="Montravers P" first="Philippe" last="Montravers">Philippe Montravers</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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