Abstract
Nosocomial pneumonia is the most common nosocomial infection in intensive care units. Rational antibiotic therapy is the basis for the treatment of nosocomial pneumonia. There is currently a challenge of the pathogens of nosocomial pneumonia being resistant to most of the antibiotics recommended for its treatment. Inhaled antibiotics used in combination with systemic drugs are an effective and safe treatment for nosocomial pneumonia. This review of literature characterizes the current possibilities of inhaled antibiotic therapy for nosocomial pneumonia in detail and describes medicaments and the advantages and disadvantages of this treatment option. Despite insufficient evidence in circumstances where the microorganisms are polyresistant and where the design of novel antibiotics shows no promise, the use of inhaled antibiotics is an important alternative in the treatment of severe nosocomial pneumonia caused by polyresistant gram-negative bacteria. Key words: nosocomial pneumonia, antibiotic therapy, inhaled antibiotics, resistance.
Highlights
Nosocomial pneumonia is the most common nosocomial infection in intensive care units
Nosocomial pneumonia (NP) — is a disease associat ed with a formation of new focal and infiltrative changes on the chest X ray 48 hrs after the hospitalization along with the clinical data confirming their infectious nature, excluding infections which were incubated on the admission [1]
Associations of 3—4 multiresistant strains of Pseudomonas aeruginosa (70—80%), Acinetobacter bau manii/calcoaceticus (70—90%), Klebsilella pneumonia (30—40%), Proteus mirabilis (20—25%) were detected in our investigation; gram positive strains were detected in 10—15% of patients (Staphylococcus aureus MRSA, Enterococcus faecalis, Enterococcus faecium) [9,10,11,12,13]
Summary
Rational antibiotic therapy is the basis for the treatment of nosocomial pneumonia. There is currently a challenge of the pathogens of nosocomial pneumonia being resistant to most of the antibiotics recommended for its treatment. Inhaled antibiotics used in combination with sys temic drugs are an effective and safe treatment for nosocomial pneumonia. This review of literature characterizes the cur rent possibilities of inhaled antibiotic therapy for nosocomial pneumonia in detail and describes medicaments and the advantages and disadvantages of this treatment option. Despite insufficient evidence in circumstances where the microor ganisms are polyresistant and where the design of novel antibiotics shows no promise, the use of inhaled antibiotics is an important alternative in the treatment of severe nosocomial pneumonia caused by polyresistant gram negative bacteria.
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