Strategie antibiotické léčby těžké komunitnípneumonie v intenzivní péči

Strategy of Antibiotic Treatment of Severe Community Acquired Pneumonia in ICU

The article is focused on optimal strategy in the antibiotic treatment of severe community-acquired pneumonia in ICU. Basicprinciples for correct and effective choice of antibiotics, based on good knowledge of the most frequent etiological agents(especially pathogens typically associated with sever infection – Streptococcus pneumoniae and Legionella pneumophila)are desribed. The strategy of microbiological diagnostics, necessary for obtaining important data for pathogen-specifictherapy of pneumonia is also described. Specific arguments are focused on problems of antibiotic resistance of respiratorypathogens in the national, European and world-wide context. There is especially critical importance of detailed andpresent-day knowledge of antibiotic resistance in the community at the national level, which has paramount impact forestablishing optimal choice of antibiotics for initial therapy in the urgent situation in the critically ill patients. The mostclinically effective pathogen-specific therapy, in the situation of known agent and its susceptibility to antibiotics is describedin detail.

Key words:
choice of antibiotics – severe pneumonitis – antibiotic resistance – prevention