Medicina (Kaunas) 2006; 42 (9): 703-708

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Empiric de-escalation strategy of antibiotic treatment

Dalia Adukauskienė, Astra Vitkauskienė1

Intensive Care Clinic, 1Institute for Biomedical Research, Kaunas University of Medicine, Lithuania

Key words: nosocomial pneumonia, ventilator-acquired pneumonia, severe sepsis, resistant organisms, de-escalation therapy, mortality.

Summary. Nosocomial pneumonia, especially ventilator-acquired pneumonia, has the greatest impact on patients’ management in intensive care unit. Inappropriate initial antimicrobial treatment increases attributable and crude mortality from ventilator-acquired pneumonia. De-escalation therapy improves short-term survival of patients with ventilator-acquired pneumonia without increasing the emergence of resistant organisms.

Correspondence to D. Adukauskienė, Clinic of Intensive Care, Kaunas University of Medicine, Eivenių 2, 50009 Kaunas, Lithuania. E-mail:

Received 28 February 2006, accepted 28 April 2006