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 journalArticlepeer-review

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

Keywords

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

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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