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dc.contributor.authorRello, J.
dc.contributor.authorUlldemolins, M.
dc.contributor.authorLisboa, T.
dc.contributor.authorTopeli, Arzu
dc.date.accessioned2020-01-30T08:12:38Z
dc.date.available2020-01-30T08:12:38Z
dc.date.issued2011
dc.identifier.issn0903-1936
dc.identifier.urihttps://doi.org/10.1183/09031936.00093010
dc.identifier.urihttps://www.scopus.com/inward/record.url?eid=2-s2.0-79957987593&partnerID=40&md5=fa65d9daddf9b0dbe729c3f7038941b1
dc.identifier.urihttp://hdl.handle.net/11655/21941
dc.description.abstractThe objectives of this study were to assess the determinants of empirical antibiotic choice, prescription patterns and outcomes in patients with hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP) in Europe. We performed a prospective, observational cohort study in 27 intensive care units (ICUs) from nine European countries. 100 consecutive patients on mechanical ventilation for HAP, on mechanical ventilation>48 h or with VAP were enrolled per ICU. Admission category, sickness severity and Acinetobacter spp. prevalence>10% in pneumonia episodes determined antibiotic empirical choice. Trauma patients were more often prescribed non-anti-Pseudomonas cephalosporins (OR 2.68, 95% CI 1.50-4.78). Surgical patients received less aminoglycosides (OR 0.26, 95% CI 0.14-0.49). A significant correlation (p<0.01) was found between Simplified Acute Physiology Score II score and carbapenem prescription. Basal Acinetobacter spp. prevalence>10% dramatically increased the prescription of carbapenems (OR 3.5, 95% CI 2.0-6.1) and colistin (OR 115.7, 95% CI 6.9-1,930.9). Appropriate empirical antibiotics decreased ICU length of stay by 6 days (26.3±19.8 days versus 32.8±29.4 days; p=0.04). The antibiotics that were prescribed most were carbapenems, piperacillin/tazobactam and quinolones. Median (interquartile range) duration of antibiotic therapy was 9 (6-12) days. Anti-methicillin-resistant Staphylococcus aureus agents were prescribed in 38.4% of VAP episodes. Admission category, sickness severity and basal Acinetobacter prevalence>10% in pneumonia episodes were the major determinants of antibiotic choice at the bedside. Across Europe, carbapenems were the antibiotic most prescribed for HAP/VAP.tr_TR
dc.language.isoentr_TR
dc.publisherEuropean Respiratory Societytr_TR
dc.relation.isversionof10.1183/09031936.00093010tr_TR
dc.rightsinfo:eu-repo/semantics/openAccesstr_TR
dc.subjectAntibiotic policytr_TR
dc.subjectAppropriate treatmenttr_TR
dc.subjectCombination therapytr_TR
dc.subjectHospital-acquired pneumoniatr_TR
dc.subjectVentilator-associated pneumoniatr_TR
dc.subject.lcshTıptr_TR
dc.titleDeterminants Of Prescription And Choice Of Empirical Therapy For Hospital-Acquired And Ventilator-Associated Pneumoniatr_TR
dc.typeinfo:eu-repo/semantics/articletr_TR
dc.typeinfo:eu-repo/semantics/publishedVersion
dc.relation.journalEuropean Respiratory Journaltr_TR
dc.contributor.departmentİç Hastalıklarıtr_TR
dc.identifier.volume37tr_TR
dc.identifier.issue6tr_TR
dc.identifier.startpage1332tr_TR
dc.identifier.endpage1339tr_TR
dc.indexingScopustr_TR
dc.fundingYoktr_TR


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