Evidence map›Paper›PMID 39115698›Full record

GuidelineInfection2024

Key summary of German national guideline for adult patients with nosocomial pneumonia- Update 2024 Funding number at the Federal Joint Committee (G-BA): 01VSF22007.

Jessica Rademacher, Santiago Ewig, Béatrice Grabein, Irit Nachtigall, Marianne Abele-Horn, Maria Deja, Martina Gaßner, Sören Gatermann, Christine Geffers, Herwig Gerlach and 17 more

Abstract readPractice Guideline
In one paragraph

Guideline in Infection, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors.

Jessica RademacherDepartment of Respiratory Medicine and Infectious Diseases, German Centre of Lung Research (DZL), Hannover Medical School, Hannover, Germany. rademacher.jessica@mh-hannover.de.
Santiago EwigDepartment of Respiratory and Infectious Diseases, Thoraxzentrum Ruhrgebiet, EVK Herne and Augusta-Kranken-Anstalt Bochum, Bochum, Germany.
Béatrice GrabeinLMU Hospital, Clinical Microbiology and Hospital Hygiene, Munich, Germany.
Irit NachtigallDivision of Infectious Diseases and Infection Prevention, Helios Hospital Emil-Von-Behring, Berlin, Germany.
Marianne Abele-HornInstitute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany.
Maria DejaDepartment of Anesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Berlin, Lübeck, Germany.
Martina GaßnerDepartment of Anaesthesiology and Intensive Care Medicine, Charité, Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.
Sören GatermannNational Reference Centre for Multidrug-Resistant Gram-Negative Bacteria, Department of Medical Microbiology, Ruhr-University Bochum, Bochum, Germany.
Christine GeffersCharité, Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Germany.
Herwig GerlachDepartment for Anaesthesia, Intensive Care Medicine and Pain Management, Vivantes-Klinikum Neukoelln, Berlin, Germany.
Stefan HagelInstitute for Infectious Diseases and Infection Control, Jena University Hospital-Friedrich Schiller University Jena, Jena, Germany.
Claus Peter HeußelDiagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany.
Stefan KlugeDepartment of Intensive Care, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Martin KolditzDivision of Pulmonology, Medical Department 1, University Hospital of TU Dresden, Dresden, Germany.
Evelyn KrammeDepartment of Infectious Diseases and Microbiology, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Germany.
Hilmar KühlDepartment of Radiology, St. Bernhard-Hospital Kamp-Lintfort, Bürgermeister-Schmelzing-Str. 90, 47475, Kamp-Lintfort, Germany.
Marcus PanningInstitute of Virology, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Peter-Michael RathInstitute for Medical Microbiology, University Medicine Essen, Essen, Germany.
Gernot RohdeDepartment of Respiratory Medicine, Goethe University Frankfurt, University Hospital, Frankfurt/Main, Germany.
Bernhard SchaafDepartment of Respiratory Medicine and Infectious Diseases, Klinikum Dortmund, Dortmund, Germany.
Helmut J F SalzerDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine-Pneumology, Kepler University Hospital, Medical Faculty, Johannes Kepler University, Linz, Austria.
Dierk SchreiterDepartment of Intensive Care Medicine, Helios Park Clinic, Leipzig, Germany.
Hans SchweisfurthInstitute for Pulmonary Research (IPR), Cottbus, Germany.
Susanne UnverzagtInstitute of General Practice and Family Medicine, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
Markus A WeigandDepartment of Anesthesiology, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany.
Tobias WelteDepartment of Respiratory Medicine and Infectious Diseases, German Centre of Lung Research (DZL), Hannover Medical School, Hannover, Germany.
Mathias W PletzInstitute for Infectious Diseases and Infection Control, Jena University Hospital-Friedrich Schiller University Jena, Jena, Germany.

Funding

Bundesministerium für Gesundheit 01VSF22007
6 · The paper itself

Abstract

purposeThis executive summary of a German national guideline aims to provide the most relevant evidence-based recommendations on the diagnosis and treatment of nosocomial pneumonia.

methodsThe guideline made use of a systematic assessment and decision process using evidence to decision framework (GRADE). Recommendations were consented by an interdisciplinary panel. Evidence analysis and interpretation was supported by the German innovation fund providing extensive literature searches and (meta-) analyses by an independent methodologist. For this executive summary, selected key recommendations are presented including the quality of evidence and rationale for the level of recommendation.

resultsThe original guideline contains 26 recommendations for the diagnosis and treatment of adults with nosocomial pneumonia, thirteen of which are based on systematic review and/or meta-analysis, while the other 13 represent consensus expert opinion. For this key summary, we present 11 most relevant for everyday clinical practice key recommendations with evidence overview and rationale, of which two are expert consensus and 9 evidence-based (4 strong, 5 weak and 2 open recommendations). For the management of nosocomial pneumonia patients should be divided in those with and without risk factors for multidrug-resistant pathogens and/or Pseudomonas aeruginosa. Bacterial multiplex-polymerase chain reaction (PCR) should not be used routinely. Bronchoscopic diagnosis is not considered superior to´non-bronchoscopic sampling in terms of main outcomes. Only patients with septic shock and the presence of an additional risk factor for multidrug-resistant pathogens (MDRP) should receive empiric combination therapy. In clinically stabilized patients, antibiotic therapy should be de-escalated and focused. In critically ill patients, prolonged application of suitable beta-lactam antibiotics should be preferred. Therapy duration is suggested for 7-8 days. Procalcitonin (PCT) based algorithm might be used to shorten the duration of antibiotic treatment. Patients on the intensive care unit (ICU) are at risk for invasive pulmonary aspergillosis (IPA). Diagnostics for Aspergillus should be performed with an antigen test from bronchial lavage fluid.

conclusionThe current guideline focuses on German epidemiology and standards of care. It should be a guide for the current treatment and management of nosocomial pneumonia in Germany.

Indexed as

Healthcare-Associated PneumoniaAdultAnti-Bacterial AgentsCross InfectionGermanyHumansAnti-Bacterial AgentsAntimicrobial stewardshipGerman guidelineNosocomial pneumoniaSeptic shockVentilator-associated pneumonia

Identifiers

PMID39115698
PMCPMC11621171

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.