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- Olga Diaz, Emili Diaz, and Jordi Rello.
- Critical Care Department, Hospital Doce de Octubre, Madrid, Spain.
- Infect. Dis. Clin. North Am. 2003 Dec 1; 17 (4): 697-705.
AbstractThe information gathered here helps to explain why risk factors in the development of VAP vary from series to series. It also explains why different investigators have found opposite effects when evaluating the antibiotics. Antibiotic therapy has a bimodal effect in the development of VAP. Antibiotics protect against pneumonia development within the first days of MV, especially against types caused by endogenous flora, but they are responsible for selection of a set of resistant pathogens that are associated with significant attributable mortality, such as P aeruginosa and MRSA. These observations suggest that risk factors vary depending on the exposure to risk (ie, length of stay or MV). This variable should be considered when stratifying patients for risk factor analysis and also in the design of clinical trials for VAP prophylaxis.
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