PMID- 15320439
OWN - NLM
STAT- MEDLINE
DCOM- 20040907
LR  - 20161209
IS  - 0755-4982 (Print)
IS  - 0755-4982 (Linking)
VI  - 33
IP  - 12 Pt 2
DP  - 2004 Jul 10
TI  - [Stakes, treatment strategies and progression of MRSA nosocomial pneumonia, 
      especially pneumonia due to mechanical ventilation].
PG  - 2S5-9
AB  - THE IMPORTANCE OF THE INITIAL TREATMENT: Many studies have shown excess mortality 
      during acquired pneumonia with mechanical ventilation when the initial antibiotic 
      treatment is inappropriate, even following subsequent adaptation of the latter. 
      EFFICACY OF TREATMENT: From a clinical point of view, since the regression of the 
      various signs appears after varying time lapses, it is not easy to judge within 
      the first three days the efficacy of an antibiotic. From a microbiological point 
      of view, the bacterial concentrations observed at the time of diagnosis decrease 
      within the first two days, when the response to treatment is favorable. PROBLEMS 
      WITH VANCOMYCIN: Treatment of reference in the case of gram+ germ infections, 
      vancomycin currently fails in 40% of MRSA pneumonias acquired under mechanical 
      ventilation. The probable reason for such failure is an insufficient local 
      concentration, which does not exceed the minimal inhibiting concentration (MIC) 
      of the germ. BETWEEN EFFICACY AND TOLERANCE: The increase in the MIC of 
      vancomycin in the serum and the lungs during acute MRSA acquired under mechanical 
      ventilation may provoke problems in tolerance, notably renal.
FAU - Wunderink, R G
AU  - Wunderink RG
AD  - Methodist Healthcare, University of Tennessee, Memphis, USA.
LA  - fre
PT  - English Abstract
PT  - Journal Article
PT  - Review
TT  - Enjeux, strategies de traitement et evolution des pneumonies nosocomiales a SARM, 
      notamment les pneumonies acquises sous ventilation mecanique.
PL  - France
TA  - Presse Med
JT  - Presse medicale (Paris, France : 1983)
JID - 8302490
RN  - 0 (Anti-Bacterial Agents)
RN  - 6Q205EH1VU (Vancomycin)
SB  - IM
MH  - Acute Disease
MH  - Anti-Bacterial Agents/metabolism/pharmacology/*therapeutic use
MH  - Critical Care/*methods
MH  - Cross Infection/etiology/metabolism/mortality/*therapy
MH  - Disease Progression
MH  - Drug Monitoring
MH  - Hospital Mortality
MH  - Humans
MH  - Kidney Diseases/chemically induced
MH  - *Methicillin Resistance
MH  - Microbial Sensitivity Tests
MH  - Patient Selection
MH  - Pneumonia, Bacterial/etiology/metabolism/mortality/*therapy
MH  - Prognosis
MH  - Respiration, Artificial/*adverse effects
MH  - Staphylococcal Infections/etiology/metabolism/mortality/*therapy
MH  - *Staphylococcus aureus
MH  - Survival Analysis
MH  - Treatment Outcome
MH  - Vancomycin/metabolism/pharmacology/therapeutic use
RF  - 10
EDAT- 2004/08/24 05:00
MHDA- 2004/09/08 05:00
CRDT- 2004/08/24 05:00
PHST- 2004/08/24 05:00 [pubmed]
PHST- 2004/09/08 05:00 [medline]
PHST- 2004/08/24 05:00 [entrez]
PST - ppublish
SO  - Presse Med. 2004 Jul 10;33(12 Pt 2):2S5-9.