Khunkit Pirawan, Siripaitoon Pisud, Lertsrisatit Yongyut, Watthanapaisal Dissaya, Kositpantawong Narongdet, Kanchanasuwan Siripen, Cheh-Oh Nadia, Chittrakarn Sorawit, Jaroenmark Tanapat, Poonchuay Natnicha, Chusri Sarunyou
Department of Pharmaceutical Care, School of Pharmacy, Walailak University, Tha Sala, Nakhon Si Thammarat 80160, Thailand.
Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.
Antibiotics (Basel). 2024 Aug 3;13(8):729. doi: 10.3390/antibiotics13080729.
This retrospective study was conducted to evaluate the characteristics and outcomes of patients with ventilator-associated pneumonia (VAP) caused by (), focusing on the impact of appropriate empirical antimicrobial treatment. Of the enrolled 240 patients with VAP due to (median age: 45 years) in a tertiary-care hospital in southern Thailand between January 2010 and December 2021, 90% had medical comorbidities and 91% had previously received carbapenems. In addition, only 45% of the patients were initially admitted to the intensive care unit. Patients administered appropriate empirical antimicrobial treatment including colistin alone and colistin plus TMP-SMX or fluoroquinolone-based regimens had significantly lower 14-day, 30-day, and in-hospital mortalities, compared with those who did not receive appropriate empirical antimicrobial treatment (21% and 2% vs. 31%; 30% and 5% vs. 44%; and 30% and 12% vs. 53%, respectively). Thus, the use of appropriate empirical antimicrobial treatments led to a significantly reduced length of hospital stay, duration of ventilation, and hospital costs. The current study suggests that the use of appropriate empirical antimicrobial treatment based on susceptibility testing without considering pharmacokinetic properties and administration dosages improves the outcomes of patients with VAP due to .
本回顾性研究旨在评估由（）引起的呼吸机相关性肺炎（VAP）患者的特征和结局，重点关注适当的经验性抗菌治疗的影响。在2010年1月至2021年12月期间，泰国南部一家三级医院纳入的240例因（）导致VAP的患者（中位年龄：45岁）中，90%有合并症，91%曾接受过碳青霉烯类药物治疗。此外，仅45%的患者最初入住重症监护病房。与未接受适当经验性抗菌治疗的患者相比，接受包括单独使用黏菌素以及黏菌素加复方磺胺甲恶唑或氟喹诺酮类方案在内的适当经验性抗菌治疗的患者，其14天、30天和住院死亡率显著降低（分别为21%和2% vs. 31%；30%和5% vs. 44%；30%和12% vs. 53%）。因此，使用适当的经验性抗菌治疗可显著缩短住院时间、通气时间并降低住院费用。当前研究表明，基于药敏试验而不考虑药代动力学特性和给药剂量使用适当的经验性抗菌治疗可改善因（）导致VAP患者的结局。
