Consensus document on controversial issues for the treatment of hospital-associated pneumonia

International Journal of Infectious Diseases

Volumn 14, Issue SUPPL. 4, 2010, Pages

  Franzetti, Fabio ^a   Antonelli, Massimo ^b   Bassetti, Matteo ^c   Blasi, Francesco ^d   Langer, Martin ^d   Scaglione, Francesco ^d   Nicastri, Emanuele ^e,f   Lauria, Francesco N ^e,f   Carosi, Giampiero ^e,g   Moroni, Mauro ^a,e   Ippolito, Giuseppe ^e,f  

^a UNIVERSITY OF MILAN   (Italy)

^b CATHOLIC UNIVERSITY   (Italy)

^c UNIVERSITY OF GENOA   (Italy)

^d UNIVERSITY OF MILAN   (Italy)

^e GISIG Gruppo Italiano di Studio sulle Infezioni Gravi Coordinating Committee   (Italy)

^f NATIONAL INSTITUTE FOR INFECTIOUS DISEASES L SPALLANZANI   (Italy)

^g UNIVERSITY OF BRESCIA   (Italy)

Author keywords

Health care associated pneumonia; Methicillin resistant staphylococci; Nosocomial pneumonia

Indexed keywords

AMIKACIN; AMINOGLYCOSIDE ANTIBIOTIC AGENT; ANTIBIOTIC AGENT; BETA LACTAM ANTIBIOTIC; CARBAPENEM; CEFEPIME; CEFTAZIDIME; CEPHALOSPORIN DERIVATIVE; CIPROFLOXACIN; LATAMOXEF; LEVOFLOXACIN; MEROPENEM; PIPERACILLIN PLUS TAZOBACTAM; VANCOMYCIN;

ANTIBIOTIC THERAPY; ARTICLE; CLINICAL PRACTICE; CONSENSUS DEVELOPMENT; DRUG DOSE ESCALATION; DRUG EFFICACY; EVIDENCE BASED MEDICINE; GRAM NEGATIVE BACTERIUM; GRAM POSITIVE BACTERIUM; HOSPITAL INFECTION; HUMAN; ITALY; METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS; METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS INFECTION; MONOTHERAPY; MORTALITY; NEPHROTOXICITY; PNEUMONIA; PRACTICE GUIDELINE; RISK ASSESSMENT; SUPERINFECTION; SYSTEMATIC REVIEW; TREATMENT RESPONSE; VENTILATOR ASSOCIATED PNEUMONIA;

ANTI-BACTERIAL AGENTS; CROSS INFECTION; DRUG THERAPY, COMBINATION; EVIDENCE-BASED MEDICINE; GRAM-POSITIVE BACTERIA; GRAM-POSITIVE BACTERIAL INFECTIONS; HUMANS; PNEUMONIA, BACTERIAL; RANDOMIZED CONTROLLED TRIALS AS TOPIC; TREATMENT OUTCOME;

EID: 78149280030     PISSN: 12019712     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.ijid.2010.05.008     Document Type: Article

References (99)

1. Bowton D.L. Nosocomial pneumonia in the ICU-year 2000 and beyond. Chest 1999, 115(3 Suppl):28S-33S.
2. Kollef M. Ventilator-associated pneumonia. JAMA 1993, 270:1965-1970.
3. Richards M.J., Edwards J.R., Culver D.H., Gaynes R.P. Nosocomial infections in medical intensive care units in the United States. National Nosocomial Infections Surveillance System. Crit Care Med 1999, 27:887-892.
4. Chastre J., Fagon J.Y. Ventilator-associated pneumonia. Am J Respir Crit Care Med 2002, 165:867-903.
5. Warren D.K., Shukla S.J., Olsen M.A., Kollef M.H., Hollenbeak C.S., Cox M.J., et al. Outcome and attributable cost of ventilator-associated pneumonia among intensive care unit patients in a suburban medical center. Crit Care Med 2003, 31:1312-1317.
6. Safdar N., Dezfulian C., Collard H.R., Saint S. Clinical and economic consequences of ventilator-associated pneumonia: a systematic review. Crit Care Med 2005, 33:2184-2193.
7. Fagon J.Y., Chastre J., Hance A.J., Domart Y., Trouillet J.L., Gibert C. Evaluation of clinical judgment in the identification and treatment of nosocomial pneumonia in ventilated patients. Chest 1993, 103:547-553.
8. Kollef M.H., Sherman G., Ward S., Fraser V.J. Inadequate antimicrobial treatment of infections: a risk factor for hospital mortality among critically ill patients. Chest 1999, 115:462-474.
9. Dupont H., Mentec H., Sollet J.P., Bleichner G. Impact of appropriateness of initial antibiotic therapy on the outcome of ventilator-associated pneumonia. Intensive Care Med 2001, 27:355-362.
10. Iregui M., Ward S., Sherman G., Fraser V.J., Kollef M.H. Clinical importance of delays in the initiation of appropriate antibiotic treatment for ventilator-associated pneumonia. Chest 2002, 122:262-268.
11. Soriano A., Martinez J.A., Mensa J., Marco F., Almela M., Moreno-Martinez A., et al. Pathogenic significance of methicillin resistance for patients with Staphylococcus aureus bacteremia. Clin Infect Dis 2000, 30:368-373.
12. Zahar J.R., Clec'h C., Tafflet M., Garrouste-Orgeas M., Jamali S., Mourvillier B., et al. Is methicillin resistance associated with a worse prognosis in Staphylococcus aureus ventilator-associated pneumonia?. Clin Infect Dis 2005, 41:1224-1231. Outcomerea Study Group.
13. Lodise T.P., McKinnon P.S., Swiderski L., Rybak M.J. Outcomes analysis of delayed antibiotic treatment for hospital-acquired Staphylococcus aureus bacteremia. Clin Infect Dis 2003, 36:1418-1423.
14. American Thoracic, Society Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med 2005, 171:388-416.
15. Rello J., Ausina V., Ricart M., Castella J., Prats G. Impact of previous antimicrobial therapy on the etiology and outcome of ventilator-associated pneumonia. Chest 1993, 104:1230-1235.
16. Trouillet J.L., Chastre J., Vuagnat A., Joly-Guillou M.L., Combaux D., Dombret M.C., et al. Ventilator-associated pneumonia caused by potentially drug-resistant bacteria. Am J Respir Crit Care Med 1998, 157:531-539.
17. Masterton R., Craven D., Rello J., Struelens M., Frimodt-Moller N., Chastre J., et al. Hospital-acquired pneumonia guidelines in Europe: a review of their status and future development. J Antimicrob Chemother 2007, 60:206-213.
18. Safdar N., Handelsman J., Maki D.G. Does combination antimicrobial therapy reduce mortality in Gram-negative bacteraemia? A meta-analysis. Lancet Infect Dis 2004, 4:519-527.
19. Hilf M., Yu V.L., Sharp J., Korvick J.A., Muder R.R. Antibiotic therapy for Pseudomonas aeruginosa bacteremia: outcome correlations in a prospective study of 200 patients. Am J Med 1989, 87:540-546.
20. Klastersky J., Zinner S.H. Synergistic combinations of antibiotics in Gram-negative bacillary infections. Rev Infect Dis 1982, 4:294-301.
21. Kollef M.H., Micek S.T. Staphylococcus aureus pneumonia: a 'superbug' infection in community and hospital settings. Chest 2005, 128:1093-1097.
22. Craig W.A. Pharmacokinetic/pharmacodynamic parameters: rationale for antibacterial dosing of mice and men. Clin Infect Dis 1998, 26:1-10.
23. Dudley M.N., Ambrose P.G. Pharmacodynamics in the study of drug resistance and establishing in vitro susceptibility breakpoints: ready for prime time. Curr Opin Microbiol 2000, 3:515-521.
24. Andes D., Craig W.A. Pharmacodynamics of the new fluoroquinolone gatifloxacin in murine thigh and lung infection models. Antimicrob Agents Chemother 2002, 46:1665-1670.
25. Ambrose P.G., Grasela D.M., Grasela T.H., Passarell J., Mayer H.B., Pierce P.F. Pharmacodynamics of fluoroquinolones against Streptococcus pneumoniae in patients with community-acquired respiratory tract infections. Antimicrob Agents Chemother 2001, 45:2793-2797.
26. Van Wart S., Phillips L., Ludwig E.A., Russo R., Gajjar D.A., Bello A., et al. Population pharmacokinetics and pharmacodynamics of garenoxacin in patients with community-acquired respiratory tract infections. Antimicrob Agents Chemother 2004, 48:4766-4777.
27. Lodise T.P., Preston S., Bhargava V., Bryskier A., Nusrat R., Chapel S., et al. Pharmacodynamics of an 800-mg dose of telithromycin in patients with community-acquired pneumonia caused by extracellular pathogens. Diagn Microbiol Infect Dis 2005, 52:45-52.
28. Höffken G., Niederman M.S. Nosocomial pneumonia: the importance of a de-escalating strategy for antibiotic treatment of pneumonia in the ICU. Chest 2002, 122:2183-2196.
29. Niederman M.S. De-escalation therapy in ventilator-associated pneumonia. Curr Opin Crit Care 2006, 12:452-457.
30. Lisboa T., Rello J. De-escalation in lower respiratory tract infections. Curr Opin Pulm Med 2006, 12:364-368.
31. Luna C.M., Monteverde A., Rodríguez A., Apezteguia C., Zabert G., Ilutovich S., et al. Grupo Argentino-Latino Americano de Estudio de la Neumonía Nosocomial (GALANN). Clinical guidelines for the treatment of nosocomial pneumonia in Latin America: an interdisciplinary consensus document. Recommendations of the Latin American Thoracic Society. Arch Broncopneumol 2005, 41:439-456.
32. Masterton R.G., Galloway A., French G., Street M., Armstrong J., Brown E., et al. Guidelines for the management of hospital-acquired pneumonia in the UK: report of the working party on hospital-acquired pneumonia of the British Society for Antimicrobial Chemotherapy. J Antimicrob Chemother 2008, 62:5-34.
33. Muscedere J., Dodek P., Keenan S., Fowler R., Cook D., Heyland D. Comprehensive evidence-based clinical practice guidelines for ventilator-associated pneumonia: diagnosis and treatment. J Crit Care 2008, 23:138-147. VAP Guidelines Committee and the Canadian Critical Care Trials Group.
34. Aarts M.A., Hancock J.N., Heyland D., McLeod R.S., Marshall J.C. Empiric antibiotic therapy for suspected ventilator-associated pneumonia: a systematic review and meta-analysis of randomized trials. Crit Care Med 2008, 36:108-117.
35. Heyland D.K., Dodek P., Muscedere J., Day A., Cook D. Randomized trial of combination versus monotherapy for the empiric treatment of suspected ventilator-associated pneumonia. Crit Care Med 2008, 36:737-744. Canadian Critical Care Trials Group.
36. Chaudhary M., Shrivastava S.M., Varughese L., Sehgal R. Efficacy and safety evaluation of fixed dose combination of cefepime and amikacin in comparison with cefepime alone in treatment of nosocomial pneumonia patients. Curr Clin Pharmacol 2008, 3:118-122.
37. Alvarez-Lerma F., Alvarez B., Luque P., Ruiz F., Dominguez-Roldan J.M., Quintana E., Sanz-Rodriguez C. Empiric broad-spectrum antibiotic therapy of nosocomial pneumonia in the intensive care unit: a prospective observational study. Crit Care 2006, 10:R78. ADANN Study Group.
38. Joffe A.R., Muscedere J., Marshall J.C., Su Y., Heyland D.K. The safety of targeted antibiotic therapy for ventilator-associated pneumonia: a multicenter observational study. J Crit Care 2008, 23:82-90. Canadian Critical Care Trials Group.
39. Leone M., Garcin F., Bouvenot J., Boyadjev I., Visintini P., Albanèse J., et al. Ventilator-associated pneumonia: breaking the vicious circle of antibiotic overuse. Crit Care Med 2007, 35:379-385.
40. Kollef M.H., Kollef K.E. Antibiotic utilization and outcomes for patients with clinically suspected ventilator-associated pneumonia and negative quantitative BAL culture results. Chest 2005, 128:2706-2713.
41. Lauria F.N., De Carli G., Nicastri E. Resistant and multi-resistant Gram-positive severe infections: the GISIG working methodology. Int J Infect Dis 2010, 14:S13-S17.
42. Rubinstein E., Lode H., Grassi C. Ceftazidime monotherapy vs. ceftriaxone/tobramycin for serious hospital-acquired Gram-negative infections. Clin Infect Dis 1995, 20:1217-1228.
43. Sieger B., Berman S.J., Geckler R.W., Farkas S.A. Empiric treatment of hospital-acquired lower respiratory tract infections with meropenem or ceftazidime with tobramycin: a randomized study. Crit Care Med 1997, 25:1663-1670.
44. Mangi R.J., Greco T., Ryan J., Thornton G., Andriole V.T. Cefoperazone vs. combination antibiotic therapy of hospital-acquired pneumonia. Am J Med 1988, 84:68-74.
45. Cometta A., Baumgartner J.D., Lew D., Zimmerli W., Pittet D., Chopart P., et al. Prospective randomized comparison of imipenem monotherapy with imipenem plus netilmicin for treatment of severe infections in nonneutropenic patients. Antimicrob Agents Chemother 1994, 38:1309-1313.
46. Fink M.P., Snydman D.R., Niederman M.S., Leeper K.V., Johnson R.H., Heard S.O., et al. Treatment of severe pneumonia in hospitalized patients: results of a multicenter, randomized, double blind trial comparing intravenous ciprofloxacin with imipenem-cilastatin. Antimicrob Agents Chemother 1994, 38:547-557.
47. Alvarez-Lerma F. Efficacy of meropenem as monotherapy in the treatment of ventilator-associated pneumonia. J Chemother 2001, 13:70-81.
48. Kljucar S., Heimesaat M., von Pritzbuer E., Olms K. Ceftazidime with and without tobramycin vs. azlocillin plus tobramycin in the therapy of bronchopulmonary infections in intensive care patients. Infection 1987, 15:S185-S191.
49. Brown R.B., Lemeshow S., Teres D. Moxalactam vs. carbenicillin plus tobramycin: treatment of nosocomial Gram-negative bacillary pneumonias in non-neutropenic patients. Curr Ther Res 1984, 36:557-564.
50. Mouton Y.J., Beuscart C. Empirical monotherapy with meropenem in serious bacterial infections. J Antimicrob Chemother 1995, 36:S145-S156.
51. Cone L.A., Woodard D.R., Stoltzman D.S., Byrd R.G. Ceftazidime versus treatment of pneumonia and bacteremia. Antimicrob Agents Chemother 1985, 28:33-36.
52. Gao D.W., Liu C.L., Zhang J.C. Observation of the therapeutic effect of cefepime in the treatment of nosocomial pneumonia. Chin Pharm J 1999, 34:624-626.
53. Mandell L.A., Nicolle L.E., Ronald A.R., Duperval R., Robson H.G., Feld R., et al. A multicentre prospective randomized trial comparing ceftazidime with cefazolin/tobramycin in the treatment of hospitalized patients with non-pneumococcal pneumonia. J Antimicrob Chemother 1983, 12:9-20.
54. Warren J.W., Miller E.H., Fitzpatrick B., DiFranco D.E., Caplan E.S., Tenney J.H., et al. A randomized, controlled trial of cefoperazone vs. cefamandole-tobramycin in the treatment of putative, severe infections with Gram-negative bacilli. Rev Infect Dis 1983, 5(Suppl):S173-S180.
55. Koehler C.O., Arnold H. Controlled clinical study of ceftazidime (3×1g daily) versus piperacillin+tobramycin in patients with nosocomial pneumonia. Int J Exp Clin Chemother 1990, 3:211-218.
56. Mandell L.A., Nicolle L.E., Ronald A.R., Landis S.J., Duperval R., Harding G.K., et al. A prospective randomized trial of ceftazidime versus cefazolin/tobramycin in the treatment of hospitalized patients with pneumonia. J Antimicrob Chemother 1987, 20:95-107.
57. Fernández-Guerrero M., Gudiol F., Rodriguez-Torres A., Arnau C., Valdés L., Vallvé C. Nosocomial pneumonia: comparative multicentre trial between monotherapy with cefotaxime and treatment with antibiotic combinations. Infection 1991, 19(Suppl 6):S320-S325.
58. Speich R., Imhof E., Vogt M., Grossenbacher M., Zimmerli W. Efficacy, safety, and tolerance of piperacillin/tazobactam compared to co-amoxiclav plus an aminoglycoside in the treatment of severe pneumonia. Eur J Clin Microbiol Infect Dis 1998, 17:313-317.
59. Manhold C., von Rolbicki U., Brase R., Timm J., von Pritzbuer E., Heimesaat M., et al. Outbreaks of Staphylococcus aureus infections during treatment of late onset pneumonia with ciprofloxacin in a prospective, randomized study. Intensive Care Med 1998, 24:1327-1330.
60. Damas P., Garweg C., Monchi M., Nys M., Canivet J.L., Ledoux D., et al. Combination therapy vs. monotherapy: a randomised pilot study on the evolution of inflammatory parameters after ventilator associated pneumonia. Crit Care 2006, 10:R52.
61. Muscedere J., Heyland D.K., Dodek P., Day A., Cook D.J. A randomized trial of empiric broad-spectrum antibiotics and invasive diagnostic techniques for suspected ventilator-associated pneumonia. Am J Respir Crit Care Med 2006, 3:A525.
62. Mouton Y., Deboscker Y., Bazin C., Fourrier F., Moulront S., Philippon A., et al. Prospective, randomized, controlled study of imipenem-cilastatin vs. cefotaxime-amikacin in the treatment of lower respiratory tract infection and septicemia at intensive care units. Presse Med 1990, 19:607-612.
63. Rapp R.P., Young B., Foster T.S., Tibbs P.A., O'Neal W. Ceftazidime vs. tobramycin/ticarcillin in treating hospital acquired pneumonia and bacteremia. Pharmacotherapy 1984, 4:211-215.
64. Jeffres M.N., Isakow W., Doherty J.A., McKinnon P.S., Ritchie D.J., Micek S.T., et al. Predictors of mortality for methicillin-resistant Staphylococcus aureus health-care-associated pneumonia: specific evaluation of vancomycin pharmacokinetic indices. Chest 2006, 130:947-955.
65. Jeffres M.N., Isakow W., Doherty J.A., Micek S.T., Kollef M.H. A retrospective analysis of possible renal toxicity associated with vancomycin in patients with health care-associated methicillin-resistant Staphylococcus aureus pneumonia. Clin Ther 2007, 29:1107-1115.
66. Drusano G.L., Preston S.L., Fowler C., Corrado M., Weisinger B., Kahn J. Relationship between fluoroquinolone area under the curve: minimum inhibitory concentration ratio and the probability of eradication of the infecting pathogen, in patients with nosocomial pneumonia. J Infect Dis 2004, 189:1590-1597.
67. Moise P.A., Forrest A., Bhavnani S.M., Birmingham M.C., Schentag J.J. Area under the inhibitory curve and a pneumonia scoring system for predicting outcomes of vancomycin therapy for respiratory infections by Staphylococcus aureus. Am J Health Syst Pharm 2000, 57(Suppl 2):S4-9.
68. Moise-Broder P.A., Forrest A., Birmingham M.C., Schentag J.J. Pharmacodynamics of vancomycin and other antimicrobials in patients with Staphylococcus aureus lower respiratory tract infections. Clin Pharmacokinet 2004, 43:925-942.
69. Wysocki M., Delatour F., Faurisson F., Rauss A., Pean Y., Misset B., et al. Continuous versus intermittent infusion of vancomycin in severe staphylococcal infections: prospective multicenter randomized study. Antimicrob Agents Chemother 2001, 45:2460-2467.
70. Hidayat L.K., Hsu D.I., Quist R., Shriner K.A., Wong-Beringer A. High-dose vancomycin therapy for methicillin-resistant Staphylococcus aureus infections: efficacy and toxicity. Arch Intern Med 2006, 166:2138-2144.
71. Singh N., Rogers P., Atwood C.W., Wagener M.M., Yu V.L. Short-course empiric antibiotic therapy for patients with pulmonary infiltrates in the intensive care unit. A proposed solution for indiscriminate antibiotic prescription. Am J Respir Crit Care Med 2000, 162:505.
72. Pugin J., Auckenthaler R., Mili N., Janssens J.P., Lew P.D., Suter P.M. Diagnosis of ventilator-associated pneumonia by bacteriologic analysis of bronchoscopic and nonbronchoscopic 'blind' bronchoalveolar lavage fluid. Am Rev Respir Dis 1991, 143:1121-1129.
73. Micek S.T., Ward S., Fraser V.J., Kollef M.H. A randomized controlled trial of an antibiotic discontinuation policy for clinically suspected ventilator-associated pneumonia. Chest 2004, 125:1791-1799.
74. Ibrahim E.H., Ward S., Sherman G., Schaiff R., Fraser V.J., Kollef M.H. Experience with a clinical guideline for the treatment of ventilator-associated pneumonia. Crit Care Med 2001, 29:1109-1115.
75. Soo Hoo G.W., Wen Y.E., Nguyen T.V., Goetz M.B. Impact of clinical guidelines in the management of severe hospital-acquired pneumonia. Chest 2005, 128:2778-2787.
76. Dellit T.H., Chan J.D., Skerrett S.J., Nathens A.B. Development of a guideline for the management of ventilator-associated pneumonia based on local microbiologic findings and impact of the guideline on antimicrobial use practices. Infect Control Hosp Epidemiol 2008, 29:525-533.
77. Lancaster J.W., Lawrence K.R., Fong J.J., Doron S.I., Garpestad E., Nasraway S.A., et al. Impact of an institution-specific hospital-acquired pneumonia protocol on the appropriateness of antibiotic therapy and patient outcomes. Pharmacotherapy 2008, 28:852-862.
78. Luna C.M., Vujacich P., Niederman M.S., Vay C., Gherardi C., Matera J., et al. Impact of BAL data on the therapy and outcome of ventilator associated pneumonia. Chest 1997, 111:676-685.
79. Fagon J.Y., Chastre J., Wolff M., Gervais C., Parer-Aubas S., Stéphan F., et al. Invasive and noninvasive strategies for management of suspected ventilator-associated pneumonia. A randomized trial. Ann Intern Med 2000, 132:621-630.
80. Rubinstein E., Cammarata S., Oliphant T., Wunderink R. Linezolid (PNU-100766) versus vancomycin in the treatment of hospitalized patients with nosocomial pneumonia: a randomized, double-blind, multicenter study. Clin Infect Dis 2001, 32:402-412. Linezolid Nosocomial Pneumonia Study group.
81. Wunderink R.G., Cammarata S.K., Oliphant T.H., Kollef M.H. Continuation of a randomized, double-blind, multicenter study of linezolid versus vancomycin in the treatment of patients with nosocomial pneumonia. Clin Ther 2003, 25:980-992. Linezolid Nosocomial Pneumonia Study group.
82. th ICAAC 2008, the BAP00248/307 Study Group, abstract K-486.
83. Wilcox M., Nathwani D., Dryden M. Linezolid compared with teicoplanin for the treatment of suspected or proven Gram-positive infections. J Antimicrob Chemother 2004, 53:335-344.
84. Cepeda J.A., Whitehouse T., Cooper B., Hails J., Jones K., Kwaku F., et al. Linezolid versus teicoplanin in the treatment of Gram-positive infections in the critically ill: a randomized, double-blind, multicentre study. J Antimicrob Chemother 2004, 53:345-355.
85. Forrest A., Nix D.E., Ballow C.H., Goss T.F., Birmingham M.C., Schentag J.J. Pharmacodynamics of intravenous ciprofloxacin in seriously ill patients. Antimicrob Agents Chemother 1993, 37:1073-1081.
86. Scaglione F., Esposito S., Leone S., Lucini V., Pannacci M., Ma L., et al. Feedback dose alteration significantly affects probability of pathogen eradication in nosocomial pneumonia. Eur Respir J 2009, 34:394-400.
87. Darko W., Medicis J.J., Smith A., Guharoy R., Lehmann D.E. Mississippi mud no more: cost-effectiveness of pharmacokinetic dosage adjustment of vancomycin to prevent nephrotoxicity. Pharmacotherapy 2003, 23:643-650.
88. Boselli E., Breilh D., Rimmele T. Pharmacokinetics and intrapulmonary concentrations of levofloxacin in critically ill patients with severe community-acquired pneumonia. Crit Care Med 2005, 33:104-109.
89. Conte J.E., Golden J., Duncan S., McKenna E., Lin E., Zurlinden E. Single-dose intrapulmonary pharmacokinetics of azithromycin, clarithromycin, ciprofloxacin, and cefuroxime in volunteer subjects. Antimicrob Agents Chemother 1996, 40:1617-1622.
90. Conte J.E., Golden J.A., Kipps J., Zurlinden E. Intrapulmonary pharmacokinetics of linezolid. Antimicrob Agents Chemother 2002, 46:1475-1480.
91. Boselli E., Breilh D., Rimmelé T., Djabarouti S., Toutain J., Chassard D., et al. Pharmacokinetics and intrapulmonary concentrations of linezolid administered to critically ill patients with ventilator-associated pneumonia. Crit Care Med 2005, 33:1529-1533.
92. Lamer C., de Beco V., Soler P., Calvat S., Fagon J.Y., Dombret M.C., et al. Analysis of vancomycin entry into pulmonary lining fluid by bronchoalveolar lavage in critically ill patients. Antimicrob Agents Chemother 1993, 37:281-286.
93. Cruciani M., Gatti G., Lazzarini L., Furlan G., Broccali G., Malena M., et al. Penetration of vancomycin into human lung tissue. J Antimicrob Chemother 1996, 38:865-869.
94. Rello J., Vidaur L., Sandiumenge A., Rodríguez A., Gualis B., Boque C., et al. De-escalation therapy in ventilator-associated pneumonia. Crit Care Med 2004, 32:2183-2190.
95. Chastre J., Wolff M., Fagon J.Y., Chevret S., Thomas F., Wermert D., et al. Comparison of 8 vs. 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial. JAMA 2003, 290:2588-2598. PneumA Trial Group.
96. Sierra R., Benítez E., León C., Rello J. Prevention and diagnosis of ventilator-associated pneumonia: a survey on current practices in Southern Spanish ICUs. Chest 2005, 128:1667-1673.
97. Rello J., Lorente C., Bodí M., Diaz E., Ricart M., Kollef M.H. Why do physicians not follow evidence-based guidelines for preventing ventilator-associated pneumonia?: a survey based on the opinions of an international panel of intensivists. Chest 2002, 122:656-661.
98. Heyland D.K., Cook D.J., Griffith L., Keenan S.P., Brun-Buisson C. The attributable morbidity and mortality of ventilator-associated pneumonia in the critically ill patient. The Canadian Critical Trials Group. Am J Respir Crit Care Med 1999, 159:1249-1256.
99. Ruiz M., Torres A., Ewig S., Marcos M.A., Alcòn A., Lledò R., et al. Noninvasive versus invasive microbiological investigation in VAP. Am J Respir Crit Care Med 2000, 162:119-125.