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La resistencia bacteriana, necesidad de innovación. dr. ian m. gould
1. Dr. Ian M. Gould Medical Microbiology Aberdeen Royal Infirmary Empirical Antibiotic Therapy; a Need for Innovation “ At least the waiting lists are improving - I only had to wait one week to get MRSA”
20. Jan 96 Jan 97 Jan 98 Jan 99 Jan 00 % MRSA Sum of lagged antimicrobial series % MRSA Total ab. Consumption: DDD/1000 bed days Relationship between % MRSA and antibiotic use. (3 rd GC, FQ, MAC) Emerg. Inf. Dis 2004, 1432 3 rd GC lags = 4 – 7 months FQ lags = 4 & 5 months MAC lags = 1 – 3 months
38. Incidence of inadequate antibiotic therapy in hospitals N=147 N =1255 N = 34 n = 146 N = 27 Bloodstream infection Nosocomial/Ventialor-associated pneumonia Ibrahim et al Chest 2000; 118:146-155 Leibovici et al J Intern Med 1998; 244:379-386 Luna et al Chest 1997; 111:676-685. Alvarez-Lerma Inten Care Med 1996; 22:387-394 Rello et al Am J Respir Crit Care 1997; 156:196-200
39. Bloodstream infections Nosocomial/Ventilator-associated pneumonia Influence of inadequate antibiotic therapy on mortality Ibrahim et al Chest 2000; 118:146-155 Leibovici et al J Intern Med 1998; 244:379-386 Luna et al Chest 1997; 111:676-685. Alvarez-Lerma Inten Care Med 1996; 22:387-394 Rello et al Am J Respir Crit Care 1997; 156:196-200
40. For Septic shock: Each hour delay in antibiotic initiation over the first 6 hours has been shown to be associated with an average decrease in survival of 7.6% Adapted from Kumar A, Critical Care medicine 2006 Vol.34, No 6.
