Source: lancet infectious diseases, press release january.

In cases of suspected multidrug-resistant, some antibiotics may not always be the best

environment, Jan. 19 (HealthDay News) - Intensive care patients who may be infected with strains of pneumonia resistant to many drugs can be more likely to die if current guidelines for treatment should be, according to a new study. The results indicate the need to revise the American thoracic society (ATS) and Infectious Diseases Society of America (IDSA) guidelines, say researchers. Current guidelines require immediate antibiotic treatment - to the culture results are known - from patients at risk of multidrug-resistant (MDR-infection). The guidelines state that patients should receive mode three antibiotics: two drugs against so-called gram-negative pathogens and one drug against methicillin-resistant Staphylococcus aureus

, or MRSA. The logic of this approach is that at least one drug should be active on any possible infectious agents. However, several studies conducted with the guidelines issued in 2005 was able to show that double gram-negative therapy is better than treatment with one drug, the researchers noted. For their research team led by Dr. Daniel Kett from the University of Miami Miller School of Medicine, enrolled 303 patients at risk of MDR pneumonia from four academic medical centers in the United States. Of those patients, 129 were treated according to the ATS / IDSA guidelines and 174 received different treatment. Survival after 28 days was 65 percent in the compliant group and 79 percent in the group that did not adhere to the principles, the researchers found. "Our results further question the need for a combination of Gram-negative empirical therapy in patients with pneumonia, even those who are seriously ill and the risk of multidrug-resistant pathogens," the researchers wrote. One expert was not surprised by the results. "Who gets pneumonia with resistant bacteria? This is a person in such a weakened state, they are vulnerable to pathogens that might be trivial, "said Dr. Bruce Hirsch, attending physician in infectious diseases division at the north coast of the University Hospital in Manhasset, New York" This is a man has received numerous infections and has been exhibited at several courses of antibiotics. This is a man with structural abnormalities of the lungs that prevent recovery from lung infections. "

According to Hirsch, the new study "demonstrates high mortality rates in patients treated with antibiotics is recommended, as well as individual antibiotics. Even in this age of sophisticated and powerful medication adherence better guidelines could not us. "

For its part, the authors study "recommends that the planned revised ATS-IDSA guidelines be revised to broad implementation. Since the most common cause of failure was the refusal of recycling against gram-negative drugs we offer comparison charts of MRSA treatment and a comparison with double gram-negative coverage. "

The study was published in the Jan. 19 online edition

Lancet Infectious Diseases. For more information, American Lung Association has more. SOURCE: Lancet Infectious Diseases, Press Release strattera, January 19, 2011, Bruce Hirsch, MD, physician, infectious disease division, North Shore University Hospital, Manhasset, New York Copyright 2011. All rights reserved. .