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| Name | Class |
|---|---|
| Ain Shams University | OTHER |
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The study has been conducted to measure the clinical outcome of early intervention with colistin inhalation in patients with ventilator associated pneumonia suspected to have multidrug resistant gram -ve bacteria
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Medication arm | Experimental | Colistin to be given as 2 millions three times daily in the inhalation form from 5 to 7 days in addition to another antipseudomonal antibiotic according to infectious disease society of antimicrobials (IDSA) guidelines from day 1 of incidence of ventilator associated pneumonia |
|
| Control arm | Active Comparator | Patients receive antipseudomonal antibiotics IV as carbapenem and quinolone or aminoglycoside according to IDSA guidelines from day 1 of incidence of Ventilator associated pneumonia carbapenem as 1g three times daily + tavanic 750mg once daily or ciprofloxacin 500mg twice daily or aminoglycoside according to renal function |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Colistin | Drug | Polymyxins are bactericidal drugs that bind to lipopolysaccharides (LPS) and phospholipids in the outer cell membrane of gram-negative bacteria. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Assessment of Ventilatory status | Pf ratio measurement | 7 to 10 days |
| Measure | Description | Time Frame |
|---|---|---|
| Days of mechanical ventilation | Deescalation in the ventilation mode and trials until successful weaning. | 35 Days |
| Time till the occurence of sepsis | long standing ventilator associated pneumonia with failure of treatment can lead to sepsis |
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Inclusion Criteria:
Patients presenting with signs of infection 48 hours of intubation
Exclusion Criteria:
Cystic fibrosis Known allergy to polymyxin. Patients presenting with chest infection or signs of infection before intubation.
Patients with creatinine clearance less than 30ml/min.
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Number of patients ,statistical data, method,discussion and outcome will be shared
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| ID | Term |
|---|---|
| D053717 | Pneumonia, Ventilator-Associated |
| ID | Term |
|---|---|
| D000077299 | Healthcare-Associated Pneumonia |
| D003428 | Cross Infection |
| D007239 | Infections |
| D011014 | Pneumonia |
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| ID | Term |
|---|---|
| D003091 | Colistin |
| D015780 | Carbapenems |
| D000617 | Aminoglycosides |
| D015363 | Quinolones |
| ID | Term |
|---|---|
| D011113 | Polymyxins |
| D010456 | Peptides, Cyclic |
| D047028 | Macrocyclic Compounds |
| D011083 | Polycyclic Compounds |
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|
| Carbapenem + Aminoglycoside/ Quinolone | Drug | Dual antipseudomonal given as IV for ventilator associated pneumonia for patients with Multi-drug resistant bacteria risk factors |
|
|
| 35 Days |
| Mortality as an outcome of long stand untreatable ventilator associated pneumonia | is the mortality due to sepsis of other causes | 35 days |
| Length of stay in the icu | How long will the patient stay in the ICU according to failure of weaning and progression of the disease. | 35 days |
| D012141 |
| Respiratory Tract Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D007049 | Iatrogenic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D055666 |
| Lipopeptides |
| D008055 | Lipids |
| D023181 | Antimicrobial Cationic Peptides |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D000089882 | Antimicrobial Peptides |
| D052899 | Pore Forming Cytotoxic Proteins |
| D008565 | Membrane Proteins |
| D011506 | Proteins |
| D047090 | beta-Lactams |
| D007769 | Lactams |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
| D006027 | Glycosides |
| D002241 | Carbohydrates |
| D011804 | Quinolines |