Antibiotic therapy for ventilator-associated tracheobronchitis: a standard of care to reduce pneumonia, morbidity and costs?

Current Opinion in Pulmonary Medicine
Donald E CravenJawad Rashid

Abstract

The present review draws our attention to ventilator-associated tracheobronchitis (VAT) as a distinct clinical entity that has been associated with progression to ventilator-associated pneumonia (VAP) and worse patient outcomes. In contrast to VAP, which has been extensively investigated for over the past 30 years, most VAT studies have been conducted in the past decade. There are ample data which demonstrate that VAT may progress to VAP, have more ventilator days, and have longer ICU stay that may translate into higher healthcare costs. The article focuses on the diagnostic criteria for VAT, causative agents, and studies analyzing associations between VAT and patient outcomes in relation to early, appropriate intravenous, and/or aerosolized antibiotic therapy. Aerosolized antibiotic treatment delivered by improved device technology is a novel approach that has proved to be effective for the treatment and eradication of multidrug-resistant bacterial pathogens. Aerosolized antibiotics are effective in decreasing the use of systemic antibiotics, reducing bacterial resistance, and may also facilitate clinical resolution of infection. Evidence presented in this review supports treatment of VAT with early and appropriate antibiotic ...Continue Reading

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Apr 13, 2017·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·M H Kollef, S T Micek
Feb 6, 2017·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Lukas StulikEszter Nagy
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Sep 30, 2016·Critical Care : the Official Journal of the Critical Care Forum·Donald E CravenAhsan Waqas

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Methods Mentioned

BETA
bronchoalveolar lavage

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