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Provedor de dados:  BJID
País:  Brazil
Título:  Ventilator-associated pneumonia: the influence of bacterial resistance, prescription errors, and de-escalation of antimicrobial therapy on mortality rates
Autores:  Souza-Oliveira,Ana Carolina
Cunha,Thúlio Marquez
Passos,Liliane Barbosa da Silva
Lopes,Gustavo Camargo
Gomes,Fabiola Alves
Röder,Denise Von Dolinger de Brito
Data:  2016-10-01
Ano:  2016
Palavras-chave:  Ventilator-associated pneumonia
Bacterial resistance
Prescription errors
De-escalation of antibiotic therapy
Resumo:  Abstract Ventilator-associated pneumonia is the most prevalent nosocomial infection in intensive care units and is associated with high mortality rates (14–70%). Aim This study evaluated factors influencing mortality of patients with Ventilator-associated pneumonia (VAP), including bacterial resistance, prescription errors, and de-escalation of antibiotic therapy. Methods This retrospective study included 120 cases of Ventilator-associated pneumonia admitted to the adult adult intensive care unit of the Federal University of Uberlândia. The chi-square test was used to compare qualitative variables. Student's t-test was used for quantitative variables and multiple logistic regression analysis to identify independent predictors of mortality. Findings De-escalation of antibiotic therapy and resistant bacteria did not influence mortality. Mortality was 4 times and 3 times higher, respectively, in patients who received an inappropriate antibiotic loading dose and in patients whose antibiotic dose was not adjusted for renal function. Multiple logistic regression analysis revealed the incorrect adjustment for renal function was the only independent factor associated with increased mortality. Conclusion Prescription errors influenced mortality of patients with Ventilator-associated pneumonia, underscoring the challenge of proper Ventilator-associated pneumonia treatment, which requires continuous reevaluation to ensure that clinical response to therapy meets expectations.
Tipo:  Info:eu-repo/semantics/article
Idioma:  Inglês
Identificador:  http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702016000500437
Editor:  Brazilian Society of Infectious Diseases
Relação:  10.1016/j.bjid.2016.06.006
Formato:  text/html
Fonte:  Brazilian Journal of Infectious Diseases v.20 n.5 2016
Direitos:  info:eu-repo/semantics/openAccess
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