Korean J Crit Care Med.  2007 Jun;22(1):1-6.

Clinical Outcomes of Early Vancomycin Administration before Identification of Methicillin-resistant Staphylococcus aureus in Patients with Nosocomial Pneumonia

• Seo YW
• Lee JE
• Min BR
• Park JS
• Kim JE
• Jang YY
• Park HP
• Ryoo NH
• Choi WI

Abstract

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. CONCLUSIONS: Early vancomycin administration before identification of MRSA does not appear to affect the mortality rate for patients with nosocomial pneumonia.

Keyword

Methicillin-resistant Staphylocoreccus aureus; Nosocomial pneumonia; Tracheal aspiration; Vancomycin

MeSH Terms

Body Temperature
Humans
Inpatients
Leukocyte Count
Lung
Methicillin Resistance*
Methicillin-Resistant Staphylococcus aureus*
Mortality
Pneumonia*
Respiration, Artificial
Retrospective Studies
Vancomycin*
Ventilators, Mechanical
Vancomycin