The particularities of antibacterial treatment in nosocomial pneumonia in patients with comorbidities

Nosocomial pneumonia is one of the causes of medical complications and deaths among patients hospitalized in medical institution. The significant use of antibacterials and the causes of failure of antibiotic therapy of nosocomial pneumonia require continuous reevaluation and detailed approach. The study was analytical, retrospective based on 45 medical records of patients with nosocomial pneumonia treated in the „Gheorghe Paladi” Municipal Clinical Hospital. Th e analysis of medical records determined the prevalence of nosocomial pneumonia in the elderly with the predominance of pneumonia associated with specialized medical care. Antibiogram data reported that Gram negative bacteria, including Klebsiella pneumoniae, with a high degree of resistance, were the most frequent causes of nosocomial pneumonia. Antimicrobial therapy in most cases was combined and it achieved by rational synergistic or allowed associations. Cardiovascular, renal and liver diseases were the comorbidities associated with nosocomial pneumonias in hospitalized patients, which, together with the degree of resistance to antimicrobial preparations, constituted an important factor in the selection and prescription of antibacterial treatment. Antibiotic therapy was prescribed according to the national clinical protocol for nosocomial pneumonias. Th e prescription of the combined antimicrobial treatment, respecting the pharmacokinetic and pharmacodynamic peculiarities of the antibacterial preparations, did not determine the expected results in all cases, the lethality constituting 44% of the cases. The objective of the study consisted in the analysis of the factors, such as: the pharmacological aspects of the antibacterial preparations, the physiological and pathological peculiarities in the elderly, the associated pathologies; that are responsible for the effectiveness of antibiotic therapy in patients with nosocomial pneumonia.