Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Ventilator-associated pneumonia: monotherapy is optimal if chosen wisely. | Available online http content 10 2 141 Commentary Ventilator-associated pneumonia monotherapy is optimal if chosen wisely Burke A Cunha Infectious Disease Division Winthrop-University Hospital Mineola New York and State University of New York School of Medicine Stony Brook New York USA Corresponding author Burke A Cunha editorial@ Published 20 April 2006 This article is online at http content 10 2 141 2006 BioMed Central Ltd Critical Care 2006 10 141 doi cc4908 See related research by Damas et al. in this issue http content 10 2 R52 Abstract Traditionally ventilator-associated pneumonia VAP has been treated either with double drug therapy or with monotherapy. Double drug therapy has been used to increase spectrum for possible synergy and to decrease the emergence of resistance. VAP therapy should be directed primarily against Pseudomonas aeruginosa which also provides aerobic Gram-negative coverage the usual pathogens in VAP. The potent anti-P. aeruginosa antibiotics available today have sufficient activity that double drug coverage is unnecessary. Double drug therapy does not decrease resistance if a high resistance potential antibiotic is used in the combination. The study by Damas and colleagues in this issue of Critical Care supports monotherapy for VAP. Optimal therapy for VAP involves selecting a potent anti-P. aeruginosa antibiotic with a low resistance potential that minimizes drug-drug interactions minimizes resistance and is cost effective. Monotherapy of VAP should be the standard of care. Empiric antimicrobial therapy of ventilator-associated pneumonia VAP should possess a high degree of activity against aerobic Gram-negative bacilli GNB . Although Pseudomonas aeruginosa is not the most common VAP pathogen it is clearly the most virulent Gram-negative pathogen. Antibiotics with a high degree of P. aeruginosa activity are also effective against other aerobic GNB causing VAP that is Escherichia coli .
