In this episode, we will be discussing empiric therapy for hospital acquired pneumonia (HAP), what is it, when to suspect it, how to manage it while you’re on the wards.
The listener will be able to do the following by the end of the episode:
-Recognize the most common presenting history and findings for HAP
-Recognize the most common pathogens associated with HAP
-Understand appropriate use of empiric antibiotic therapies given the clinical situation
-Understand the use of screening tests for quick de-escalation of antibiotics
-Recognize narrowing and treatment length of antibiotic therapies
The thumbnail of this podcast is a Sankey diagram detailing the prescription patterns and de-escalation trends of how our teaching teams are managing hospital acquired pneumonia with vancomycin. Overall, vancomycin is the most commonly used empiric treatment for any infectious indication among our teaching teams. The first "node" (furthest left on plot) indicates day 1 of antibiotic use, followed by days 2, 3 and 4 with each subsequent node. As you can see, most patients continue into days 2 and 3 for vancomycin use before they it is stopped without transition to other medications. In other words, about 40% of the vancomycin started are continued past day 2; ultimately, only 20% of vancomycin prescriptions started become used for therapeutic purposes beyond day 3. With MRSA PCR tests, we can de-escalate more readily and reduce days of therapy for vancomycin.
This dataset excluded patient for research and patients with cystic fibrosis. Patients included in this dataset were admitted onto the hospital medicine service only.
Please help us make this podcast better! Complete the survey https://redcap.hitchcock.org/redcap/surveys/?s=T44XY4ECR9Clin Infect Dis. 2016;63(5):e61. Epub 2016 Jul 14.
Infect Control Hosp Epidemiol. 2007;28(7):825. Epub 2007 May 17.