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KMID : 0604020070220010001
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Korean Journal of Critical Care Medicine
2007 Volume.22 No. 1 p.1 ~ p.6
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Clinical Outcomes of Early Vancomycin Administration before Identification of Methicillin-resistant Staphylococcus aureus in Patients with Nosocomial Pneumonia
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Seo Yong-Woo
Park Hun-Pyo
Lee Jeong-Eun
Park Jae-Seok
Ryoo Nam-Hee
Min Bo-Ram
Kim Jung-Eun
Jang Young-Yun
Choi Won-Il
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Abstract
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Background: The aim of this study is to determine the clinical outcomes of early vancomycin administration before identification of methicillin-resistant Staphylococcus aureus (MRSA) in patients with nosocomial pneumonia on a ventilator.
Methods: We retrospectively reviewed patients with nosocomial pneumonia in a 20-bed medical ICU during a period of 2 years and 2 months. This study included 52 inpatients, who were admitted for more than 72 hr and had a new or progressive lung infiltrate plus at least two of the following three criteria for pneumonia: abnormal body temperature (>38oC or <35oC), abnormal leukocyte count (>10,000/mm3 or <3,000/mm3), and purulent bronchial secretions. All of the MRSA were identified in tracheal aspirates during mechanical ventilation.
Results: A total of 23 patients who received vancomycin prior to identification of MRSA exhibited a 28-day mortality rate of 60%, while 29 patients who received vancomycin after identification of MRSA showed a 28-day mortality rate of 40% (p=0.17). There was no statistically significant difference in severity index and routine laboratory findings between the two groups.
Conclusion: Early vancomycin administration before identification of MRSA does not appear to affect the mortality rate for patients with nosocomial pneumonia.
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KEYWORD
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Methicillin-resistant Staphylocoreccus aureus, Nosocomial pneumonia, Tracheal aspiration, Vancomycin
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