Hospital-acquired pneumonia medical therapy: Difference between revisions
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* Renal toxicity were more common in [[vancomycin]] compared to [[linezolid]] | * Renal toxicity were more common in [[vancomycin]] compared to [[linezolid]] | ||
===Vancomycin trough=== | ===Vancomycin trough=== | ||
* The target vancomycin trough concentrations is 15 to 20 mcg/mL <ref name="pmid15699079">{{cite journal |author= |title=Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia |journal=[[American Journal of Respiratory and Critical Care Medicine]] |volume=171 |issue=4 |pages=388–416 |year=2005 |month=February |pmid=15699079 |doi=10.1164/rccm.200405-644ST |url=http://ajrccm.atsjournals.org/cgi/pmidlookup?view=long&pmid=15699079 |accessdate=2012-09-11}}</ref>. | * The target vancomycin trough concentrations is 15 to 20 mcg/mL <ref name="pmid15699079">{{cite journal |author= |title=Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia |journal=[[American Journal of Respiratory and Critical Care Medicine]] |volume=171 |issue=4 |pages=388–416 |year=2005 |month=February |pmid=15699079 |doi=10.1164/rccm.200405-644ST |url=http://ajrccm.atsjournals.org/cgi/pmidlookup?view=long&pmid=15699079 |accessdate=2012-09-11}}</ref>, <ref name="pmid21208910">{{cite journal |author=Liu C, Bayer A, Cosgrove SE, Daum RS, Fridkin SK, Gorwitz RJ, Kaplan SL, Karchmer AW, Levine DP, Murray BE, J Rybak M, Talan DA, Chambers HF |title=Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children |journal=[[Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America]] |volume=52 |issue=3 |pages=e18–55 |year=2011 |month=February |pmid=21208910 |doi=10.1093/cid/ciq146 |url=http://www.cid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=21208910 |accessdate=2012-09-11}}</ref>. | ||
===Supportive trial data <ref name="pmid22247123">{{cite journal |author=Wunderink RG, Niederman MS, Kollef MH, Shorr AF, Kunkel MJ, Baruch A, McGee WT, Reisman A, Chastre J |title=Linezolid in methicillin-resistant Staphylococcus aureus nosocomial pneumonia: a randomized, controlled study |journal=[[Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America]] |volume=54 |issue=5 |pages=621–9 |year=2012 |month=March |pmid=22247123 |doi=10.1093/cid/cir895 |url=http://www.cid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=22247123 |accessdate=2012-09-11}}</ref>=== | ===Supportive trial data <ref name="pmid22247123">{{cite journal |author=Wunderink RG, Niederman MS, Kollef MH, Shorr AF, Kunkel MJ, Baruch A, McGee WT, Reisman A, Chastre J |title=Linezolid in methicillin-resistant Staphylococcus aureus nosocomial pneumonia: a randomized, controlled study |journal=[[Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America]] |volume=54 |issue=5 |pages=621–9 |year=2012 |month=March |pmid=22247123 |doi=10.1093/cid/cir895 |url=http://www.cid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=22247123 |accessdate=2012-09-11}}</ref>=== | ||
Revision as of 18:08, 11 September 2012
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Hospital-acquired pneumonia Microchapters |
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Differentiating Hospital-Acquired Pneumonia from other Diseases |
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Hospital-acquired pneumonia medical therapy On the Web |
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Directions to Hospitals Treating Hospital-acquired pneumonia |
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Risk calculators and risk factors for Hospital-acquired pneumonia medical therapy |
Editor(s)-in-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753; Philip Marcus, M.D., M.P.H.[2]
Overview
Antimicrobial therapy
Patients prone to Methicillin-resistant staphylococcus aureus
- Critically ill patients
- History of recent antibiotic therapy
- Patient admitted in a hospital with increased incidence of MRSA.
Antibiotic choice for MRSA
- Vancomycin
- Linezolid
- Teicoplanin
- In case no MRSA is isolated on culture these antibiotics should be discontinued.
Side-effects of Linezolid
- Thrombocytopenia
- Gastrointestinal side-effects
- Renal dysfunction
Side-effects of vancomycin
- Renal toxicity were more common in vancomycin compared to linezolid
Vancomycin trough
Supportive trial data [3]
In a study done in 1184 patients treated with linezolid and vancomycin no significant difference in 60 days mortality were found between the two groups. The side-effects profile were similar in both the groups however nephrotoxicity was commoner in the vancomycin group. Linezolid was found to be non-inferior to vancomycin for clinical outcome, and microbiologic outcome at end of treatment and end of study.
References
- ↑ "Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia". American Journal of Respiratory and Critical Care Medicine. 171 (4): 388–416. 2005. doi:10.1164/rccm.200405-644ST. PMID 15699079. Retrieved 2012-09-11. Unknown parameter
|month=ignored (help) - ↑ Liu C, Bayer A, Cosgrove SE, Daum RS, Fridkin SK, Gorwitz RJ, Kaplan SL, Karchmer AW, Levine DP, Murray BE, J Rybak M, Talan DA, Chambers HF (2011). "Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children". Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 52 (3): e18–55. doi:10.1093/cid/ciq146. PMID 21208910. Retrieved 2012-09-11. Unknown parameter
|month=ignored (help) - ↑ Wunderink RG, Niederman MS, Kollef MH, Shorr AF, Kunkel MJ, Baruch A, McGee WT, Reisman A, Chastre J (2012). "Linezolid in methicillin-resistant Staphylococcus aureus nosocomial pneumonia: a randomized, controlled study". Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 54 (5): 621–9. doi:10.1093/cid/cir895. PMID 22247123. Retrieved 2012-09-11. Unknown parameter
|month=ignored (help)