| Theme | Complications of Respiratory Organs in Dialysis Patients | |
|---|---|---|
| Title | Hospital-acquired pneumonia | |
| Publish Date | 2008/07 | |
| Author | Koji Yoshikawa | Kanagawa Prefectural Shiomidai Hospital Internal Medicine |
| [ Summary ] | Hospital-acquired pneumonia (HAP) is defined as pneumonia that occurs 48 hours or more after admission. HAP is a frequent cause of nosocomial infection that is associated with higher mortality rates than other hospital-acquired infections. Early-onset HAP is more likely to be caused by antibiotic-sensitive bacteria, but late-onset HAP is more likely to be caused by multidrug-resistant pathogens. A diagnosis of HAP is suspected if the patient has a radiographic infiltrate that is new or progressive, along with clinical findings suggesting infection, which include new onset of fever, purulent sputum, leukocytosis, or a decline in oxygenation. Inappropriate therapy is a major risk factor for excess mortality. Early, appropriate, broad-spectrum, antibiotic therapy should be prescribed with adequate doses to optimize antimicrobial efficacy. The responding patient should receive a de-escalating regimen of antibiotics, narrowing therapy to the most focused regimen possible on the basis of culture data. |
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