Next Article in Journal
Evolution of Bacterial Persistence to Antibiotics during a 50,000-Generation Experiment in an Antibiotic-Free Environment
Next Article in Special Issue
Drug Regimens of Novel Antibiotics in Critically Ill Patients with Varying Renal Functions: A Rapid Review
Previous Article in Journal
A Review: Antimicrobial Therapy for Human Pythiosis
Previous Article in Special Issue
Predictor of Early Administration of Antibiotics and a Volume Resuscitation for Young Infants with Septic Shock
Review

A Narrative Review on the Approach to Antimicrobial Use in Ventilated Patients with Multidrug Resistant Organisms in Respiratory Samples—To Treat or Not to Treat? That Is the Question

1
Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong, China
2
Royal Brisbane and Women’s Hospital and Jamieson Trauma Institute, The University of Queensland, Brisbane, QLD 4029, Australia
3
Nimes University Hospital, University of Montpelier, 30900 Nimes, France
*
Author to whom correspondence should be addressed.
Academic Editor: Mehran Monchi
Antibiotics 2022, 11(4), 452; https://doi.org/10.3390/antibiotics11040452
Received: 10 March 2022 / Revised: 18 March 2022 / Accepted: 23 March 2022 / Published: 27 March 2022
(This article belongs to the Special Issue Antibiotic Usage in Acute Situations)
Multidrug resistant organisms (MDRO) are commonly isolated in respiratory specimens taken from mechanically ventilated patients. The purpose of this narrative review is to discuss the approach to antimicrobial prescription in ventilated patients who have grown a new MDRO isolate in their respiratory specimen. A MEDLINE and PubMed literature search using keywords “multidrug resistant organisms”, “ventilator-associated pneumonia” and “decision making”, “treatment” or “strategy” was used to identify 329 references as background for this review. Lack of universally accepted diagnostic criteria for ventilator-associated pneumonia, or ventilator-associated tracheobronchitis complicates treatment decisions. Consideration of the clinical context including signs of respiratory infection or deterioration in respiratory or other organ function is essential. The higher the quality of respiratory specimens or the presence of bacteremia would suggest the MDRO is a true pathogen, rather than colonization, and warrants antimicrobial therapy. A patient with higher severity of illness has lower safety margins and may require initiation of antimicrobial therapy until an alternative diagnosis is established. A structured approach to the decision to treat with antimicrobial therapy is proposed. View Full-Text
Keywords: ventilator associated pneumonia; ventilator associated tracheobronchitis; ICU; treatment; decision; multidrug resistant ventilator associated pneumonia; ventilator associated tracheobronchitis; ICU; treatment; decision; multidrug resistant
Show Figures

Figure 1

MDPI and ACS Style

Ling, L.; Wong, W.-T.; Lipman, J.; Joynt, G.M. A Narrative Review on the Approach to Antimicrobial Use in Ventilated Patients with Multidrug Resistant Organisms in Respiratory Samples—To Treat or Not to Treat? That Is the Question. Antibiotics 2022, 11, 452. https://doi.org/10.3390/antibiotics11040452

AMA Style

Ling L, Wong W-T, Lipman J, Joynt GM. A Narrative Review on the Approach to Antimicrobial Use in Ventilated Patients with Multidrug Resistant Organisms in Respiratory Samples—To Treat or Not to Treat? That Is the Question. Antibiotics. 2022; 11(4):452. https://doi.org/10.3390/antibiotics11040452

Chicago/Turabian Style

Ling, Lowell, Wai-Tat Wong, Jeffrey Lipman, and Gavin M. Joynt. 2022. "A Narrative Review on the Approach to Antimicrobial Use in Ventilated Patients with Multidrug Resistant Organisms in Respiratory Samples—To Treat or Not to Treat? That Is the Question" Antibiotics 11, no. 4: 452. https://doi.org/10.3390/antibiotics11040452

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop