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

Fabio Franzetti, Massimo Antonelli, Matteo Bassetti, Francesco Blasi, Martin Langer, Francesco Scaglione, Emanuele Nicastri, Francesco N. Lauria, Giampiero Carosi, Mauro Moroni, Giuseppe Ippolito

Research output: Contribution to journalArticle

Abstract

Background: Hospital-associated pneumonia (HAP) remains an important cause of morbidity and mortality despite advances in antimicrobial therapy. Many aspects of the treatment of HAP caused by multi-resistant Gram-positive microorganisms have been extensively studied, but controversial issues remain. Controversial issues: The aim of this GISIG (Gruppo Italiano di Studio sulle Infezioni Gravi) working group - a panel of multidisciplinary experts - was to define recommendations for some controversial issues using an evidence-based and analytical approach. The controversial issues were: (1) Is combination antibiotic therapy or monotherapy more effective in the treatment of HAP? (2) What role do pharmacokinetic/pharmacodynamic antibiotic features have as a guide in the selection of treatment for HAP? (3) Is a de-escalation approach for the management of HAP effective? An analysis of the studies published up until April 2009 is presented and discussed in detail. Methods: A systematic literature search using PubMed, MEDLINE, and EMBASE databases and the Cochrane Library was performed. A matrix was created to extract evidence from original studies using the CONSORT method to evaluate randomized clinical trials and the Newcastle-Ottawa Quality Assessment Scale for case-control studies, longitudinal cohorts, and retrospective studies. The GRADE method for grading quality of evidence was applied.

Original languageEnglish
JournalInternational Journal of Infectious Diseases
Volume14
Issue numberSUPPL. 4
DOIs
Publication statusPublished - Oct 2010

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Pneumonia
Anti-Bacterial Agents
PubMed
MEDLINE
Libraries
Longitudinal Studies
Case-Control Studies
Cohort Studies
Randomized Controlled Trials
Retrospective Studies
Pharmacokinetics
Databases
Morbidity
Mortality
Therapeutics

Keywords

  • Health care-associated pneumonia
  • Methicillin-resistant staphylococci
  • Nosocomial pneumonia

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Consensus document on controversial issues for the treatment of hospital-associated pneumonia. / Franzetti, Fabio; Antonelli, Massimo; Bassetti, Matteo; Blasi, Francesco; Langer, Martin; Scaglione, Francesco; Nicastri, Emanuele; Lauria, Francesco N.; Carosi, Giampiero; Moroni, Mauro; Ippolito, Giuseppe.

In: International Journal of Infectious Diseases, Vol. 14, No. SUPPL. 4, 10.2010.

Research output: Contribution to journalArticle

Franzetti, Fabio ; Antonelli, Massimo ; Bassetti, Matteo ; Blasi, Francesco ; Langer, Martin ; Scaglione, Francesco ; Nicastri, Emanuele ; Lauria, Francesco N. ; Carosi, Giampiero ; Moroni, Mauro ; Ippolito, Giuseppe. / Consensus document on controversial issues for the treatment of hospital-associated pneumonia. In: International Journal of Infectious Diseases. 2010 ; Vol. 14, No. SUPPL. 4.
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