Suspected nosocomial pneumonia in the intensive care unit

PANNUCI algorithm. From empirical to targeted treatment on nosocomial pneumonia in ICU. After analyzing the onset, the previous use of antimicrobials or clinical condition (vHAP or VAP), empirical antimicrobial therapy is chosen based on risk factors, previous colonization, local flora, and/or use of rapid techniques. Therefore, targeted therapy is selected depending on the type of microorganism isolated and the possible advantages of one antimicrobial over others.

ICU: intensive care unit; AT: antimicrobial therapy; vHAP: ventilated hospital-acquired pneumonia; VAP: ventilator-associated pneumonia; MDR: multidrug-resistant; PCR: polymerase chain reaction; KPC: Klebsiella pneumoniae carbapenemase; CFT/TAZ: ceftolozane/tazobactam; CAZ/AVI: ceftazidime/avibactam; PIP/TAZ: piperacillin/tazobactam; AMG: aminoglycoside; AZT: aztreonam; EAT: empirical antimicrobial treatment; TAT: targeted antimicrobial treatment; OXA-48: carbapenemase; R: resistance.
* If OXA-48 susceptible to CAZ/AVI.

From: Zaragoza R, Vidal-Cortés P, Aguilar G, et al. Update of the treatment of nosocomial pneumonia in the ICU. Crit Care 2020; 24:383. Copyright © 2020 The Authors. Available at: https://ccforum.biomedcentral.com/articles/10.1186/s13054-020-03091-2 (Accessed on August 27, 2021). Reproduced under the terms of the Creative Commons Attribution 4.0 License.

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Suspected nosocomial pneumonia in the intensive care unit