ABSTRACT
The increase in nosocomial infections by beta-lactamase producing Gram-negative bacilli constitutes a therapeutic challenge. The combination of ceftazidime-avibactam offers a very interesting therapeutic option for nosocomial pneumonia caused by extended-spectrum beta-lactamase-producing Klebsiella pneumoniae, multidrug-resistant Pseudomonas aeruginosa, and other enterobacteria. Compared to carbapenems, ceftazidime-avibactam has demonstrated non-inferiority in the treatment of nosocomial pneumonia including better clinical and microbiological cure rates and mortality compared to colistin. The limitation of ceftazidime-avibactam in the treatment of infections caused by metallo-beta-lactamase-producing Enterobacteriaceae can be overcome with the addition of aztreonam.
Subject(s)
Healthcare-Associated Pneumonia , beta-Lactamase Inhibitors , Anti-Bacterial Agents/therapeutic use , Azabicyclo Compounds , Ceftazidime , Drug Combinations , Enterobacteriaceae , Healthcare-Associated Pneumonia/drug therapy , Humans , beta-Lactamase Inhibitors/therapeutic use , beta-LactamasesSubject(s)
COVID-19 , Pneumonia , Respiratory Distress Syndrome , Antibodies, Monoclonal, Humanized , China , Humans , Methylprednisolone , Pneumonia/drug therapy , Risk Factors , SARS-CoV-2ABSTRACT
Invasive pneumococcal disease (IPD) and pneumococcal pneumonia (PP) represent an important health problem among aging adults and those with certain underlying pathologies and some diseases, especially immunosuppressed and some immunocompetent subjects, who are more susceptible to infections and present greater severity and worse evolution. Among the strategies to prevent IPD and PP, vaccination has its place, although vaccination coverage in this group is lower than desirable. Nowadays, there are 2 vaccines available for adults. Polysacharide vaccine (PPV23), used in patients aged 2 and older since decades ago, includes a greater number of serotypes (23), but it does not generate immune memory, antibody levels decrease with time, causes an immune tolerance phenomenon, and have no effect on nasopharyngeal colonization. PCV13 can be used from children 6 weeks of age to elderly and generates an immune response more powerful than PPV23 against most of the 13 serotypes included in it. In the year 2013 the 16 most directly related to groups of risk of presenting IPD publised a series of vaccine recommendations based on scientific evidence regarding anti-pneumococcal vaccination in adults with underlying pathologies and special conditions. A commitment was made about updating it if new scientific evidence became available. We present an exhaustive revised document focusing mainly in recommendation by age in which some more Scientific Societies have been involved.
Subject(s)
Pneumococcal Infections/prevention & control , Pneumococcal Vaccines , Adult , Aged , Child , Child, Preschool , Consensus , Humans , Pneumonia, Pneumococcal/prevention & control , Streptococcus pneumoniae , VaccinationABSTRACT
En el año 2013 algunas de las Sociedades Científicas más directamente relacionadas con los grupos de riesgo para padecer enfermedad neumocócica publicamos un documento de Consenso con una serie de recomendaciones basadas en las evidencias científicas respecto a la vacunación antineumocócica en el adulto con condiciones especiales y patología de base. Se estableció un compromiso de discusión y actualización ante la aparición de nuevas evidencias. Fruto de este trabajo de revisión, en abril de 2017 se ha publicado una actualización del anterior documento junto a 4 nuevas Sociedades Científicas donde destaca, entre otras novedades, la recomendación de vacunación por criterio de edad. Se resumen algunas de las principales novedades que presenta la actualización del documento de Consenso
In the year 2013 some of the most directly related to groups of risk of presenting IPD Scientific Societies published a series of vaccine recommendations based on scientific evidence regarding anti-pneumococcal vaccination in adults with underlying pathologies and special conditions. A commitment was made about updating it if new scientific evidence became available. In april 2017 an exhaustive revision over the previous document was published focusing mainly in recommendation by age. We review some of the main changes in the new Consensus document
Subject(s)
Humans , Adult , Pneumococcal Vaccines/administration & dosage , Pneumococcal Infections/prevention & control , Bacteremia/prevention & control , Chronic Disease/epidemiology , Risk GroupsABSTRACT
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