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Title

Hospital-acquired pneumonia in ICU

Authors
Leone, Marc
Bouadma, Lila
Bouhemad, Bélaïd
Brissaud, Olivier
Dauger, Stéphane
Gibot, Sébastien
Hraiech, Sami
Jung, Boris
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Published in Anaesthesia, critical care & pain medicine. 2018, vol. 37, no. 1, p. 83-98
Abstract The French Society of Anesthesia and Intensive Care Medicine and the French Society of Intensive Care edited guidelines focused on hospital-acquired pneumonia (HAP) in intensive care unit (ICU). The goal of 16 French-speaking experts was to produce a framework enabling an easier decision-making process for intensivists. The guidelines were related to 3 specific areas related to HAP (prevention, diagnosis and treatment) in 4 identified patient populations (COPD, neutropenia, postoperative and pediatric). The literature analysis and the formulation of the guidelines were conducted according to the Grade of Recommendation Assessment, Development and Evaluation methodology. An extensive literature research over the last 10 years was conducted based on publications indexed in PubMed™ and Cochrane™ databases. HAP should be prevented by a standardized multimodal approach and the use of selective digestive decontamination in units where multidrug-resistant bacteria prevalence was below 20%. Diagnosis relies on clinical assessment and microbiological findings. Monotherapy, in the absence of risk factors for multidrug-resistant bacteria, non-fermenting Gram negative bacilli and/or increased mortality (septic shock, organ failure), is strongly recommended. After microbiological documentation, it is recommended to reduce the spectrum and to prefer monotherapy for the antibiotic therapy of HAP, including for non-fermenting Gram-negative bacilli.
Keywords Anti-Bacterial Agents/therapeutic useClinical Decision-MakingCross Infection/diagnosis/microbiology/prevention & control/therapyGuidelines as TopicHealthcare-Associated Pneumonia/drug therapy/epidemiologyHumansIntensive Care UnitsRisk Factors
Identifiers
PMID: 29155054
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Article (Published version) (587 Kb) - public document Free access
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Research group Groupe Pugin Jérôme (Soins intensifs) (587)
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LEONE, Marc et al. Hospital-acquired pneumonia in ICU. In: Anaesthesia Critical Care & Pain Medicine, 2018, vol. 37, n° 1, p. 83-98. doi: 10.1016/j.accpm.2017.11.006 https://archive-ouverte.unige.ch/unige:126848

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Deposited on : 2019-11-25

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