AbdelHalim Mona Moheyeldin, El Sherbini Seham Awad, Ahmed El Shimaa Salah, Gharib Heba Abdullah Abdalbaset, Elgendy Marwa O, Ibrahim Ahmed R N, Abdel Aziz Heba Sherif
Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo 12613, Egypt.
Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo12613, Egypt.
Medicina (Kaunas). 2024 Dec 21;60(12):2098. doi: 10.3390/medicina60122098.
A dangerous infection contracted in hospitals, ventilator-associated pneumonia is frequently caused by bacteria that are resistant to several drugs. It is one of the main reasons why patients in intensive care units become ill or die. This research aimed to determine the most effective empirical therapy of antibiotics for better ventilator-associated pneumonia control and to improve patient outcomes by using the minimal inhibitory concentration method and the Ameri-Ziaei double antibiotic synergism test and by observing the clinical responses to both single and combination therapies. Patients between the ages of one month and twelve who had been diagnosed with ventilator-associated pneumonia and had been on mechanical ventilation for more than 48 h were included in the study, which was carried out in the Pediatric Intensive Care Unit at Cairo University's Hospital. When ventilator-associated pneumonia is suspected, it is critical to start appropriate antibiotic therapy as soon as possible. This is especially important in cases where multidrug-resistant Gram-negative infections may develop. Although using Polymyxins alone or in combination is effective, it is important to closely monitor their administration to prevent resistance from increasing. The combination therapy that showed the greatest improvement was a mix of aminoglycosides, quinolones, and β-lactams. A combination of aminoglycosides and dual β-lactams came next. Although the optimal duration of antibiotic treatment for ventilator-associated pneumonia is still unknown, treatments longer than seven days are usually required to eradicate MDR or completely.
呼吸机相关性肺炎是一种在医院感染的危险疾病，通常由对多种药物耐药的细菌引起。它是重症监护病房患者生病或死亡的主要原因之一。本研究旨在通过使用最低抑菌浓度法和阿梅里 - 齐亚伊双抗生素协同试验，并观察单一疗法和联合疗法的临床反应，确定最有效的抗生素经验性治疗方法，以更好地控制呼吸机相关性肺炎并改善患者预后。该研究在开罗大学医院的儿科重症监护病房进行，纳入了年龄在1个月至12岁之间、被诊断为呼吸机相关性肺炎且机械通气超过48小时的患者。当怀疑患有呼吸机相关性肺炎时，尽快开始适当的抗生素治疗至关重要。在可能发生多重耐药革兰氏阴性菌感染的情况下尤其如此。虽然单独使用或联合使用多粘菌素是有效的，但密切监测其给药以防止耐药性增加很重要。显示出最大改善的联合疗法是氨基糖苷类、喹诺酮类和β - 内酰胺类的组合。其次是氨基糖苷类和双重β - 内酰胺类的组合。虽然呼吸机相关性肺炎的最佳抗生素治疗持续时间仍不清楚，但通常需要超过7天的治疗才能根除多重耐药菌或彻底治愈。
