Clinical Outcomes of Early Vancomycin Administration before Identification of Methicillin-resistant Staphylococcus aureus in Patients with Nosocomial Pneumonia.
- Author:
Yong Woo SEO
1
;
Jung Eun LEE
;
Bo Ram MIN
;
Jae Seok PARK
;
Jeong Eun KIM
;
Young Yun JANG
;
Hun Pyo PARK
;
Nam Hee RYOO
;
Won Il CHOI
Author Information
1. Department of Medicine, Keimyung University School of Medicine, Daegu, Korea. wichoi@dsmc.or.kr
- Publication Type:Original Article
- Keywords:
Methicillin-resistant Staphylocoreccus aureus;
Nosocomial pneumonia;
Tracheal aspiration;
Vancomycin
- MeSH:
Body Temperature;
Humans;
Inpatients;
Leukocyte Count;
Lung;
Methicillin Resistance*;
Methicillin-Resistant Staphylococcus aureus*;
Mortality;
Pneumonia*;
Respiration, Artificial;
Retrospective Studies;
Vancomycin*;
Ventilators, Mechanical
- From:The Korean Journal of Critical Care Medicine
2007;22(1):1-6
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The aim of this study is to determine the clinical outcomes of early vancomycin administration before identification of methicillin-resistant Staphylococcus aureus (MRSA) in patients with nosocomial pneumonia on a ventilator. METHODS: We retrospectively reviewed patients with nosocomial pneumonia in a 20-bed medical ICU during a period of 2 years and 2 months. This study included 52 inpatients, who were admitted for more than 72 hr and had a new or progressive lung infiltrate plus at least two of the following three criteria for pneumonia: abnormal body temperature (>38oC or <35oC), abnormal leukocyte count (>10,000/mm3 or <3,000/mm3), and purulent bronchial secretions. All of the MRSA were identified in tracheal aspirates during mechanical ventilation. RESULTS: A total of 23 patients who received vancomycin prior to identification of MRSA exhibited a 28-day mortality rate of 60%, while 29 patients who received vancomycin after identification of MRSA showed a 28-day mortality rate of 40% (p=0.17). There was no statistically significant difference in severity index and routine laboratory findings between the two groups. CONCLUSIONS: Early vancomycin administration before identification of MRSA does not appear to affect the mortality rate for patients with nosocomial pneumonia.
