Hospital-acquired pneumonia - Optimal settings of the initial empirical antibiotic therapy

Abstract

Hospital-acquired pneumonia (HAP) is one of the most severe complications occurring in patients during their hospital stay and an important factor affecting the economy of health care; it is often associated with bacterial resistance. The presence of individual etiological pathogens causing HAP and their resistance to antimicrobial agents play a key role in the selection of adequate antibiotic therapy. However, not knowing these pathogens usually complicates causative antibiotic therapy at the onset of pneumonia. It takes hours to days to identify them and, in the meantime, empirical antibiotic therapy must be initiated. The usual pathogens causing HAP are endogenous bacterial strains originating from the primary microflora in early-onset HAP and secondary colonizing bacteria with a higher level of resistance in late-onset HAP. The onset of HAP is often manifested by clinical signs of sepsis and considerably worsens the prognosis of patients. Therefore, the aims were to obtain current epidemiological data on pathogens causing HAP and to determine their susceptibility to antibiotics. The results were compared with data from a protocol for reference initial empirical antibiotic therapy of HAP so that optimal initial antibiotic therapy of HAP could be set.