Hospital-acquired pneumonia medical therapy: Difference between revisions

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* Renal toxicity were more common in [[vancomycin]] compared to [[linezolid]]
* Renal toxicity were more common in [[vancomycin]] compared to [[linezolid]]
===Vancomycin trough===
===Vancomycin trough===
* The target vancomycin trough concentrations of 15 to 20 mcg/mL.
* The target vancomycin trough concentrations is 15 to 20 mcg/mL <ref name="pmid15699079">{{cite journal |author= |title=Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia |journal=[[American Journal of Respiratory and Critical Care Medicine]] |volume=171 |issue=4 |pages=388–416 |year=2005 |month=February |pmid=15699079 |doi=10.1164/rccm.200405-644ST |url=http://ajrccm.atsjournals.org/cgi/pmidlookup?view=long&pmid=15699079 |accessdate=2012-09-11}}</ref>.


===Supportive trial data <ref name="pmid22247123">{{cite journal |author=Wunderink RG, Niederman MS, Kollef MH, Shorr AF, Kunkel MJ, Baruch A, McGee WT, Reisman A, Chastre J |title=Linezolid in methicillin-resistant Staphylococcus aureus nosocomial pneumonia: a randomized, controlled study |journal=[[Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America]] |volume=54 |issue=5 |pages=621–9 |year=2012 |month=March |pmid=22247123 |doi=10.1093/cid/cir895 |url=http://www.cid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=22247123 |accessdate=2012-09-11}}</ref>===
===Supportive trial data <ref name="pmid22247123">{{cite journal |author=Wunderink RG, Niederman MS, Kollef MH, Shorr AF, Kunkel MJ, Baruch A, McGee WT, Reisman A, Chastre J |title=Linezolid in methicillin-resistant Staphylococcus aureus nosocomial pneumonia: a randomized, controlled study |journal=[[Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America]] |volume=54 |issue=5 |pages=621–9 |year=2012 |month=March |pmid=22247123 |doi=10.1093/cid/cir895 |url=http://www.cid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=22247123 |accessdate=2012-09-11}}</ref>===

Revision as of 18:07, 11 September 2012

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Editor(s)-in-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753; Philip Marcus, M.D., M.P.H.[2]

Overview

Antimicrobial therapy

Patients prone to Methicillin-resistant staphylococcus aureus

  • Critically ill patients
  • History of recent antibiotic therapy
  • Patient admitted in a hospital with increased incidence of MRSA.

Antibiotic choice for MRSA

Side-effects of Linezolid

Side-effects of vancomycin

Vancomycin trough

  • The target vancomycin trough concentrations is 15 to 20 mcg/mL [1].

Supportive trial data [2]

In a study done in 1184 patients treated with linezolid and vancomycin no significant difference in 60 days mortality were found between the two groups. The side-effects profile were similar in both the groups however nephrotoxicity was commoner in the vancomycin group. Linezolid was found to be non-inferior to vancomycin for clinical outcome, and microbiologic outcome at end of treatment and end of study.

References

  1. "Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia". American Journal of Respiratory and Critical Care Medicine. 171 (4): 388–416. 2005. doi:10.1164/rccm.200405-644ST. PMID 15699079. Retrieved 2012-09-11. Unknown parameter |month= ignored (help)
  2. Wunderink RG, Niederman MS, Kollef MH, Shorr AF, Kunkel MJ, Baruch A, McGee WT, Reisman A, Chastre J (2012). "Linezolid in methicillin-resistant Staphylococcus aureus nosocomial pneumonia: a randomized, controlled study". Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 54 (5): 621–9. doi:10.1093/cid/cir895. PMID 22247123. Retrieved 2012-09-11. Unknown parameter |month= ignored (help)

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