Individual research recommendation details

Recommendation ID

CG191/4

Question

Can rapid microbiological diagnosis of hospital-acquired pneumonia reduce the use of xtendedspectrum antibiotic therapy, without adversely affecting outcomes?

Any explanatory notes
(if applicable)

Data are limited on the microbiology of hospital-acquired pneumonia to guide antibiotic therapy. Hospital-acquired infections can be caused by highly resistant pathogens that need treatment with extended-spectrum antibiotics (for example, extended-spectrum penicillins, third-generation cephalosporins, aminoglycosides, carbapenems, linezolid, vancomycin, or teicoplanin), as recommended by British Society of Antimicrobial Chemotherapy guidance. Because routine microbial tests lack sensitivity and take 24–48 hours to identify a causative pathogen, patient characteristics are used to guide antibiotic choice. However, this may lead to unnecessary use of
extended-spectrum antibiotics in patients infected with non-resistant organisms, and inappropriate use of first-line antibiotics (such as beta-lactam stable penicillins, macrolides or doxycycline) in patients infected with resistant organisms. Rapid diagnostic tests to identify causative bacterial pathogens and determine whether they are resistant to antibiotics may have a role in guiding antibiotic choice for postoperative hospital-acquired pneumonia.

Source guidance details

Comes from guidance

Pneumonia in adults: diagnosis and management

Number

CG191

Date issued

December 2014

Other details