Consensus document on controversial issues for the treatment of hospital-associated pneumonia

Antonio Cascio, Francesco N. Lauria, Mauro Moroni, Giampiero Carosi, Matteo Bassetti, Francesco Blasi, Fabio Franzetti, Emanuele Nicastri, Francesco Scaglione, Massimo Antonelli, Giuseppe Ippolito, Martin Langer

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Abstract

Background: Hospital-associated pneumonia (HAP) remains an important cause of morbidity andmortality despite advances in antimicrobial therapy. Many aspects of the treatment of HAP caused bymulti-resistant Gram-positive microorganisms have been extensively studied, but controversial issuesremain.Controversial issues: The aim of this GISIG (Gruppo Italiano di Studio sulle Infezioni Gravi) working group– a panel of multidisciplinary experts – was to define recommendations for some controversial issuesusing an evidence-based and analytical approach. The controversial issues were: (1) Is combinationantibiotic therapy or monotherapy more effective in the treatment of HAP? (2) What role dopharmacokinetic/pharmacodynamic antibiotic features have as a guide in the selection of treatment forHAP? (3) Is a de-escalation approach for the management of HAP effective? An analysis of the studiespublished up until April 2009 is presented and discussed in detail.Methods: A systematic literature search using PubMed, MEDLINE, and EMBASE databases and theCochrane Library was performed. A matrix was created to extract evidence from original studies usingthe CONSORT method to evaluate randomized clinical trials and the Newcastle–Ottawa QualityAssessment Scale for case–control studies, longitudinal cohorts, and retrospective studies. The GRADEmethod for grading quality of evidence was applied. 2010 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved
Lingua originaleEnglish
pagine (da-a)S55-S65
Numero di pagine16
RivistaInternational Journal of Infectious Diseases
Volume14
Stato di pubblicazionePublished - 2010

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

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    Cascio, A., Lauria, F. N., Moroni, M., Carosi, G., Bassetti, M., Blasi, F., Franzetti, F., Nicastri, E., Scaglione, F., Antonelli, M., Ippolito, G., & Langer, M. (2010). Consensus document on controversial issues for the treatment of hospital-associated pneumonia. International Journal of Infectious Diseases, 14, S55-S65.