Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Is bronchoalveolar lavage with quantitative cultures a useful tool for diagnosing ventilator-associated pneumonia? | Available online http content 11 2 123 Commentary Is bronchoalveolar lavage with quantitative cultures a useful tool for diagnosing ventilator-associated pneumonia Jean-Yves Fagon1 Jean Chastre2 and Jean-Jacques Rouby3 1 Réanimation Médicale Hôpital Européen Georges Pompidou Assistance Publique-Hôpitaux de Paris Université Paris-Descartes Paris France 2Réanimation Médicale Groupe Hospitalier Pitié-Salpêtrière Assistance Publique-Hôpitaux de Paris Université Pierre et Marie Curie of Paris-6 France 3Réanimation Chirurgicale Groupe Hospitalier Pitié-Salpêtrière Assistance Publique-Hôpitaux de Paris Université Pierre et Marie Curie of Paris-6 France Corresponding author Jean-Yves Fagon Published 16 April 2007 This article is online at http content 11 2 123 2007 BioMed Central Ltd Critical Care 2007 11 123 doi cc5724 Abstract The results of a recently published Canadian study suggest that bronchoalveolar lavage and endotracheal aspiration are associated with similar clinical outcomes and similar overall use of antibiotics in critically ill patients with suspected ventilator-associated pneumonia VAP . The study however does not provide convincing information on the best strategy to diagnose VAP to accurately choose initial treatment and to exclude VAP in order to avoid administering antibiotics to patients without bacterial infection. In fact this trial has several limitations or drawbacks patients at risk for developing VAP due to Pseudomonas aeruginosa or methicillin-resistant Staphylococcus aureus were excluded far from the real-life scenario a significant number of patients were receiving recent antimicrobial therapy at the time of sampling with consequently difficult-to-interpret culture results randomization of included patients for initial treatment - meropenem plus ciprofloxacin or meropenem alone - resulted in a high rate of inappropriate initial empirical therapy due to the absence of customization to
