Early Evaluation of the Efficiency of Antibiotic Therapy for Nosocomial Pneumonia by Quantifying Lipopolysaccharide
Objective: to evaluate the efficiency of intravenous and inhaled antibiotic therapy for nosocomial pneumonia caused by gram-negative bacteria by quantifying lipopolysaccharide (LPS). Subjects and methods. Examinations were made in 54 patients with mechanical ventilation-associated nosocomial pneumon...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | Russian |
| Published: |
Russian Academy of Medical Sciences
2013-12-01
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| Series: | Obŝaâ Reanimatologiâ |
| Online Access: | https://www.reanimatology.com/rmt/article/view/90 |
| Summary: | Objective: to evaluate the efficiency of intravenous and inhaled antibiotic therapy for nosocomial pneumonia caused by gram-negative bacteria by quantifying lipopolysaccharide (LPS). Subjects and methods. Examinations were made in 54 patients with mechanical ventilation-associated nosocomial pneumonia. Conventional de-escalating intravenous antibiotic therapy (with carbapenems) was used in Group 1 (n=26). Inhaled antibiotic monotherapy with TOBI (tobramycin) in a dose of 300 mg every 12 hours for 10—12 days was performed in Group 2 (n=28). The use of inhaled tobramycin as a monodrug was due to the absence of other infection foci. LPS was quantified using a diagnostic activated particle-method-endotox spp. kit (A. N. Bakulev Research Center of Cardiovascular Surgery, Russian Academy of Medical Sciences, OOO ROKHAT Research-and-Production Firm, Russia). Results. The first administration of the antibiotic is accompanied by a higher arteriovenous difference in the content of gram-negative bacterial LPS due to increased arterial endotoxemia. Conclusion. Elevated arterial blood LPS levels after initiation of systemic or inhaled antibiotic therapy for nosocomial pneumonia may be employed as an early criterion for its efficiency. Tobramycin inhalations give rise to a significant increase in arterial lipopolysaccharidemia as compared to de-escalation therapy with carbapenems with low rates of adverse reactions and undesirable events. Key words: nosocomial pneumonia, lipopolysaccharide, arteriovenous difference, inhaled tobramycin. |
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| ISSN: | 1813-9779 2411-7110 |