Diagnosis and antibiotic therapy of nosocomial pneumonia in adults: from recommendations to real practice. A review

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Abstract

Nosocomial pneumonia is a healthcare-associated infection with significant consequences for the patient and the healthcare system. The efficacy of treatment significantly depends on the timeliness and adequacy of the antibiotic therapy regimen. The growth of resistance of gram-negative pathogens of nosocomial pneumonia to antimicrobial agents increases the risk of prescribing inadequate empirical therapy, which worsens the results of patient treatment. Identification of risk factors for infection with multidrug-resistant microorganisms, careful local microbiological monitoring with detection of resistance mechanisms, implementation of antimicrobial therapy control strategy and use of rational combinations of antibacterial drugs are of great importance. In addition, the importance of using new drugs with activity against carbapenem-resistant strains, including ceftazidime/aviabactam, must be understood. This review outlines the current data on the etiology, features of diagnosis and antibacterial therapy of nosocomial pneumonia.

About the authors

Svetlana А. Rachina

Sechenov First Moscow State Medical University (Sechenov University)

Email: Svetlana.Ratchina@antibiotic.ru
ORCID iD: 0000-0002-3329-7846

профессор РАН, доктор медицинских наук, зав. кафедры госпитальной терапии №2 Института клинической медицины имени Н.В. Склифосовского

Russian Federation, Moscow

Ludmila V. Fedina

Yudin City Clinical Hospital; Russian Medical Academy of Continuous Professional Education

Email: Svetlana.Ratchina@antibiotic.ru
ORCID iD: 0000-0002-6417-9535

врач – клинический фармаколог ГБУЗ «ГКБ имени С.С. Юдина», аспирант кафедры клинической фармакологии и терапии ФГБОУ ДПО РМАНПО

Russian Federation, Moscow; Moscow

Marina V. Sukhorukova

Burdenko National Medical Research Center for Neurosurgery

Author for correspondence.
Email: Svetlana.Ratchina@antibiotic.ru
ORCID iD: 0000-0002-1168-2356

кандидат медицинских наук, врач-бактериолог ФГАУ «НМИЦ нейрохирургии имени академика Н.Н. Бурденко»

Russian Federation, Moscow

Igor N. Sychev

Yudin City Clinical Hospital; Russian Medical Academy of Continuous Professional Education

Email: Svetlana.Ratchina@antibiotic.ru
ORCID iD: 0000-0002-2970-3442

кандидат медицинских наук, зав. отделением клинической фармакологии ГБУЗ «ГКБ имени С.С. Юдина», доцент кафедры клинической фармакологии и терапии ФГБОУ ДПО РМАНПО

Russian Federation, Moscow; Moscow

Egor S. Larin

Hospital for War Veterans №3

Email: Svetlana.Ratchina@antibiotic.ru
ORCID iD: 0000-0002-7450-6317

зам. глав. врача по анестезиологии и реаниматологии

Russian Federation, Moscow

Abdulbari A. Alkhlavov

Sechenov First Moscow State Medical University (Sechenov University)

Email: Svetlana.Ratchina@antibiotic.ru
ORCID iD: 0009-0001-3685-4775

ординатор кафедры госпитальной терапии №2 Института клинической медицины имени Н.В. Склифосовского

Russian Federation, Москва

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2. Fig. 1. Frequency of isolation of different pathogens of nosocomial pneumonia in multidisciplinary hospitals of the Russian Federation in 2019–2021 according to the data of the antibiotic resistance map (n=3970, %) [10].

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3. Fig. 2. Choice of antibiotic therapy for NP caused by carbapenem-resistant* Enterobacterales.

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