Healthcare-associated pneumonia: principles and emerging concepts on management

Authors: Chroneou, Alexandra; Zias, Nikolaos; Beamis Jr, John F; Craven, Donald E

Source: Expert Opinion on Pharmacotherapy, Volume 8, Number 18, December 2007 , pp. 3117-3131(15)

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Abstract:

Healthcare-associated pneumonia (HCAP) is a relatively new entity that includes pneumonia occurring in healthcare settings other than acute-care hospitals. Many patients with HCAP are at greater risk for colonization and infection with multi-drug resistant (MDR) bacteria such as Pseudomonas aeruginosa, Gram-negative bacilli-producing extended-spectrum β-lactamases and methicillin-resistant Staphylococcus aureus. Infections with these MDR pathogens require different empiric antibiotic therapy. To avoid initiation of inappropriate antibiotic therapy that may result in poorer patient outcomes, new principles for HCAP management were outlined in the 2005 American Thoracic Society and Infectious Diseases Society of America guidelines. These guidelines were suggested for patients assessed in acute-care hospitals and clinics, and may not be applicable for all patients with suspected HCAP in nursing homes and other long-term care settings. This review article addresses HCAP management strategies in both clinical settings.

Keywords: antibiotic; antimicrobial resistance; ATS/IDSA HAP; HCAP guideline; healthcare-associated pneumonia; multi-drug resistant bacteria; nursing home; VAP; ventilator-associated pneumonia

Document Type: Research article

DOI: http://dx.doi.org/10.1517/14656566.8.18.3117

Publication date: 2007-12-01

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