Dalhoff, K., Abele-Horn, M., Andreas, S., Deja, M., Ewig, S., Gastmeier, P., Gatermann, S., Gerlach, H., Grabein, B., Heussel, C. P., Hoeffken, G., Kolditz, M., Kramme, E., Kuehl, H., Lange, C., Mayer, K., Nachtigall, I., Panning, M., Pletz, M., Rath, P-M., Rohde, G., Rosseau, S., Schaaf, B., Schreiter, D., Schuette, H., Seifert, H., Spies, C. and Welte, T. (2018). Epidemiology, Diagnosis and Treatment of Adult Patients with Nosocomial Pneumonia - Update 2017. Pneumologie, 72 (1). S. 15 - 64. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1438-8790

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Abstract

Nosocomial pneumonia (HAP) is a frequent complication of hospital care. Most data are available on ventilator-associated pneumonia. However, infections on general wards are increasing. A central issue are infections with multidrug resistant (MDR) pathogens which are difficult to treat in the empirical setting potentially leading to inappropriate use of antimicrobial therapy. This guideline update was compiled by an interdisciplinary group on the basis of a systematic literature review. Recommendations are made according to GRADE giving guidance for the diagnosis and treatment of HAP on the basis of quality of evidence and benefit/risk ratio. This guideline has two parts. First an update on epidemiology, spectrum of pathogens and antimicrobials is provided. In the second part recommendations for the management of diagnosis and treatment are given. New recommendations with respect to imaging, diagnosis of nosocomial viral pneumonia and prolonged infusion of antibacterial drugs have been added. The statements to risk factors for infections with MDR pathogens and recommendations for monotherapy vs combination therapy have been actualised. The importance of structured deescalation concepts and limitation of treatment duration is emphasized.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Dalhoff, K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Abele-Horn, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Andreas, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Deja, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ewig, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gastmeier, P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gatermann, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gerlach, H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grabein, B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heussel, C. P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoeffken, G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kolditz, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kramme, E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuehl, H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lange, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mayer, K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nachtigall, I.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Panning, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pletz, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rath, P-M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rohde, G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rosseau, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schaaf, B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schreiter, D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schuette, H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Seifert, H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Spies, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Welte, T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-200977
DOI: 10.1055/s-0043-121734
Journal or Publication Title: Pneumologie
Volume: 72
Number: 1
Page Range: S. 15 - 64
Date: 2018
Publisher: GEORG THIEME VERLAG KG
Place of Publication: STUTTGART
ISSN: 1438-8790
Language: German
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
VENTILATOR-ASSOCIATED PNEUMONIA; RESISTANT ACINETOBACTER-BAUMANNII; HOSPITAL-ACQUIRED PNEUMONIA; INTENSIVE-CARE-UNIT; CRITICALLY-ILL PATIENTS; BRONCHOALVEOLAR LAVAGE FLUID; C-REACTIVE PROTEIN; INTERNATIONAL CONSENSUS DEFINITIONS; CLINICAL-PRACTICE GUIDELINES; INFECTIOUS-DISEASES SOCIETYMultiple languages
Respiratory SystemMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/20097

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