摘要: Pneumonia complicates hospitalization in 0.5 to 2.0% of patients and is associated with considerable morbidity mortality. Risk factors for hospital-acquired pneumonia (HAP) include mechanical ventilation > 48 h, residence an ICU, duration ICU or hospital stay, severity underlying illness, presence comorbidities. Pseudomonas aeruginosa, Staphylococcus aureus, Enterobacter are the most common causes HAP. Nearly half HAP cases polymicrobial. In receiving ventilation, P Acinetobacter, methicillin-resistant S other antibiotic-resistant bacteria assume increasing importance. Optimal therapy should take into account demographics, specific pathogens involved, risk antimicrobial resistance. When aeruginosa implicated, monotherapy, even broad-spectrum antibiotics, rapid evolution resistance a high rate clinical failures. For pseudomonal HAP, we advise combination antipseudomonal β-lactam plus aminoglycoside fluoroquinolone (eg, ciprofloxacin).
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