American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · May 2014
Multicenter Study Observational StudyAssociation between source of infection and hospital mortality in patients who have septic shock.
Mortality caused by septic shock may be determined by a systemic inflammatory response, independent of the inciting infection, but it may also be influenced by the anatomic source of infection. ⋯ Anatomic source of infection should be considered in future trial designs and analyses, and in development of prognostic scoring systems.
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Am. J. Respir. Crit. Care Med. · May 2014
Randomized Controlled TrialReduction of Bacterial Resistance with Inhaled Antibiotics in the ICU.
Multidrug-resistant organisms (MDRO) are the dominant airway pathogens in the intensive care unit (ICU) and present a major treatment challenge to intensivists. Aerosolized antibiotics (AA) result in airway concentrations of drug 100-fold greater than the minimal inhibitory concentration of most bacteria including MDRO. These levels, without systemic toxicity, may eradicate MDRO and reduce the pressure for selection of new resistant organisms. ⋯ In chronically intubated critically ill patients, AA successfully eradicated existing MDRO organisms and reduced the pressure from systemic agents for new respiratory resistance. Clinical trial registered with www.clinicaltrials.gov (NCT 01878643).
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Am. J. Respir. Crit. Care Med. · May 2014
Editorial CommentAntibiotics might do more than cause resistance.