Management of ventilator-associated pneumonia

Need for a personalized approach

Research output: Contribution to journalReview article

5 Citations (Scopus)

Abstract

Introduction: Optimizing management of ventilator-associated pneumonia (VAP) should focus on the accurate identification of true lung infection, determination of the etiological agent, and early institution of adequate empirical therapy and de-escalation. Local adaptation of the standard guidelines leads to favorable outcome in the management of VAP Areas covered: In this review, we present the concepts of early adequate therapy and the key considerations such as patient characters, clinical and etiological diagnosis, and assessment of patients for de-escalation that favor optimization of therapy. We highlight the issues that need a personalized approach in the management of VAP emphasizing on various patient categories for reassessment and tailoring the therapy. Expert commentary: Rapid diagnostic techniques and non-invasive metabolomics will identify phenotypes which will shift the traditional paradigm based on conventional cultures. A personalized approach taking into account baseline resistance epidemiology, underlying disease (and comorbidities), duration of hospitalization, and prior antimicrobial exposure should guide targeted therapy.

Original languageEnglish
Pages (from-to)641-653
Number of pages13
JournalExpert Review of Anti-Infective Therapy
Volume16
Issue number8
DOIs
Publication statusPublished - 03-08-2018

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Ventilator-Associated Pneumonia
Metabolomics
Therapeutics
Secondary Prevention
Comorbidity
Epidemiology
Hospitalization
Guidelines
Phenotype
Lung
Infection

All Science Journal Classification (ASJC) codes

  • Microbiology
  • Microbiology (medical)
  • Infectious Diseases
  • Virology

Cite this

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abstract = "Introduction: Optimizing management of ventilator-associated pneumonia (VAP) should focus on the accurate identification of true lung infection, determination of the etiological agent, and early institution of adequate empirical therapy and de-escalation. Local adaptation of the standard guidelines leads to favorable outcome in the management of VAP Areas covered: In this review, we present the concepts of early adequate therapy and the key considerations such as patient characters, clinical and etiological diagnosis, and assessment of patients for de-escalation that favor optimization of therapy. We highlight the issues that need a personalized approach in the management of VAP emphasizing on various patient categories for reassessment and tailoring the therapy. Expert commentary: Rapid diagnostic techniques and non-invasive metabolomics will identify phenotypes which will shift the traditional paradigm based on conventional cultures. A personalized approach taking into account baseline resistance epidemiology, underlying disease (and comorbidities), duration of hospitalization, and prior antimicrobial exposure should guide targeted therapy.",
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Management of ventilator-associated pneumonia : Need for a personalized approach. / Vandana Kalwaje, Eshwara; Rello, Jordi.

In: Expert Review of Anti-Infective Therapy, Vol. 16, No. 8, 03.08.2018, p. 641-653.

Research output: Contribution to journalReview article

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