Community-acquired pneumonia is a common cause for hospital admission. This article serves to summarize new updates in the definition, prognosis, and treatment, specifically of bacterial, severe community-acquired pneumonia.
In a multicenter, cluster-randomized crossover trial, researchers compared standard precautions vs. contact isolation for preventing acquisition of ESBL-producing Enterobacterales (ESBL-E) in non-intensive care unit settings. Contact isolation did not decrease the number of hospital-acquired ESBL-E cases, which questions the value of the practice.
In this prospective, randomized trial, intravenous amoxicillin-clavulanate (dosed three times daily and given for two days) administered to patients admitted with out-of-hospital cardiac arrest due to a shockable rhythm reduced the incidence of early ventilator-associated pneumonia.
Two-thirds of general medicine patients with pneumonia received excess antibiotic therapy, with 93.2% of the unnecessary duration occurring after hospital discharge. Excess antibiotic therapy did not improve mortality or morbidity outcomes, although each additional antibiotic day was associated with 3% increased odds of antibiotic-associated adverse drug events.
Antimicrobial stewardship is the responsibility of everyone involved in the care of critically ill and hospitalized patients. This review discusses some of the key principles and practices of successful antimicrobial stewardship programs, particularly as they relate to critical care.