array:23 [
  "pii" => "S1579212906603674"
  "issn" => "15792129"
  "doi" => "10.1016/S1579-2129(06)60367-4"
  "estado" => "S300"
  "fechaPublicacion" => "2004-11-01"
  "aid" => "60367"
  "copyright" => "Sociedad Española de Neumología y Cirugía Torácica (SEPAR)"
  "copyrightAnyo" => "2004"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "cita" => "Arch Bronconeumol. 2004;40:518-33"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 4765
    "formatos" => array:3 [
      "EPUB" => 97
      "HTML" => 3906
      "PDF" => 762
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S1579212906603686"
    "issn" => "15792129"
    "doi" => "10.1016/S1579-2129(06)60368-6"
    "estado" => "S300"
    "fechaPublicacion" => "2004-11-01"
    "aid" => "60368"
    "copyright" => "Sociedad Española de Neumología y Cirugía Torácica (SEPAR)"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "sco"
    "cita" => "Arch Bronconeumol. 2004;40:534-6"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2694
      "formatos" => array:3 [
        "EPUB" => 124
        "HTML" => 1871
        "PDF" => 699
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case Reports</span>"
      "titulo" => "Lung Scintigraphy With Technetium 99m Depreotide in the Assessment of Solitary Pulmonary Nodules"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "534"
          "paginaFinal" => "536"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "A&#46;C&#46; Rebollo, J&#46;M&#46; Jim&#233;nez-Hoyuela, M&#46;D&#46; Mart&#237;nez del Valle, C&#46; Fern&#225;ndez Aguirre, C&#46; Soria, J&#46;L&#46; Velasco"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "A&#46;C&#46;"
              "apellidos" => "Rebollo"
            ]
            1 => array:3 [
              "preGrado" => "Dr&#46;"
              "nombre" => "J&#46;M&#46;"
              "apellidos" => "Jim&#233;nez-Hoyuela"
            ]
            2 => array:2 [
              "nombre" => "M&#46;D&#46;"
              "apellidos" => "Mart&#237;nez del Valle"
            ]
            3 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Fern&#225;ndez Aguirre"
            ]
            4 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Soria"
            ]
            5 => array:2 [
              "nombre" => "J&#46;L&#46;"
              "apellidos" => "Velasco"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906603686?idApp=UINPBA00003Z"
    "url" => "/15792129/0000004000000011/v1_201305141823/S1579212906603686/v1_201305141823/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S1579212906603662"
    "issn" => "15792129"
    "doi" => "10.1016/S1579-2129(06)60366-2"
    "estado" => "S300"
    "fechaPublicacion" => "2004-11-01"
    "aid" => "60366"
    "copyright" => "Sociedad Espa&#241;ola de Neumolog&#237;a y Cirug&#237;a Tor&#225;cica &#40;SEPAR&#41;"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Arch Bronconeumol. 2004;40:508-17"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 4520
      "formatos" => array:3 [
        "EPUB" => 93
        "HTML" => 3145
        "PDF" => 1282
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Articles</span>"
      "titulo" => "Leak Monitoring in Noninvasive Ventilation"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "508"
          "paginaFinal" => "517"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "C&#46;A&#46; Rabec, O&#46; Reybet-Degat, P&#46; Bonniaud, A&#46; Fanton, P&#46; Camus"
          "autores" => array:5 [
            0 => array:3 [
              "preGrado" => "Dr&#46;"
              "nombre" => "C&#46;A&#46;"
              "apellidos" => "Rabec"
            ]
            1 => array:2 [
              "nombre" => "O&#46;"
              "apellidos" => "Reybet-Degat"
            ]
            2 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Bonniaud"
            ]
            3 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Fanton"
            ]
            4 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Camus"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906603662?idApp=UINPBA00003Z"
    "url" => "/15792129/0000004000000011/v1_201305141823/S1579212906603662/v1_201305141823/en/main.assets"
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Recommendations</span>"
    "titulo" => "Recommendations for the Treatment of Severe Nosocomial Pneumonia"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "518"
        "paginaFinal" => "533"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "R&#46; Jord&#224; Marcos, A&#46; Torres Mart&#237;, F&#46;J&#46; Ariza Cardenal, F&#46; &#193;lvarez Lerma, F&#46; Barcenilla Gaite"
        "autores" => array:8 [
          0 => array:5 [
            "preGrado" => "Dr&#46;"
            "nombre" => "R&#46;"
            "apellidos" => "Jord&#224; Marcos"
            "email" => array:1 [
              0 => "uci&#64;clinicarotger&#46;es"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor1"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "A&#46;"
            "apellidos" => "Torres Mart&#237;"
          ]
          2 => array:2 [
            "nombre" => "F&#46;J&#46;"
            "apellidos" => "Ariza Cardenal"
          ]
          3 => array:2 [
            "nombre" => "F&#46;"
            "apellidos" => "&#193;lvarez Lerma"
          ]
          4 => array:2 [
            "nombre" => "F&#46;"
            "apellidos" => "Barcenilla Gaite"
          ]
          5 => array:2 [
            "colaborador" => "the Expert Committee of the Working Group on Infectious Diseases of the Spanish Society of Intensive Care Medicine&#44; Critical and Coronary Units &#40;GTEI-SEMICYUC&#41;"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "fn1"
              ]
            ]
          ]
          6 => array:1 [
            "colaborador" => "the Assembly on Tuberculosis and Respiratory Infections of the Spanish Society of Pulmonology and Thoracic Surgery &#40;TIR-SEPAR&#41;"
          ]
          7 => array:1 [
            "colaborador" => "the Nosocomial Infection Study Group of the Spanish Society of Infectious Diseases and Clinical Microbiology &#40;GEIH-SEIMC&#41;&#46;"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor1"
            "etiqueta" => "&#42;"
            "correspondencia" => "Correspondence&#58; Dr&#46; R&#46; Jord&#224; Marcos&#46; Unidad de Cuidados Intensivos&#46; Cl&#237;nica Rotger&#46; Santiago Russi&#241;ol&#44; 9&#46; 07012 Palma de Mallorca&#46; Espa&#241;a"
          ]
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2004-02-23"
    "fechaAceptado" => "2004-06-03"
    "NotaPie" => array:2 [
      0 => array:2 [
        "etiqueta" => "&#42;"
        "nota" => "<p class="elsevierStyleNotepara">A list of the members of the expert committee is given at the end of this article&#46; The Wyeth Farma laboratory in Spain facilitated task force work meetings</p>"
      ]
      1 => array:1 [
        "nota" => "<p class="elsevierStyleNotepara">A complete Spanish version of this article was also published <span class="elsevierStyleItalic">inMedicina Intensiva</span> &#40;Med Intensiva 2004&#59;25&#91;5&#93;&#58;262-78&#41; and in <span class="elsevierStyleItalic">Enfermedades Infecciosasy Microbiolog&#237;a Cl&#237;nica</span> &#40;Enferm Infecc Microbiol Clin 2004&#59;22&#91;8&#93;&#58;471-85&#41;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "REFERENCES"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:103 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Modification of empiric antibiotic treatment in patients with pneumonia acquired in the intensive care unit&#46; ICU-Acquired Pneumonia Study Group"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "F &#193;lvarez Lerma"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "1996"
                        "volumen" => "22"
                        "paginaInicial" => "387"
                        "paginaFinal" => "394"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8796388"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impact of BAL data on the therapy and outcome of ventilator-associated pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "CM Luna"
                            1 => "P Vujacich"
                            2 => "MS Niederman"
                            3 => "C Vay"
                            4 => "C Gherardi"
                            5 => "J Matera"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1997"
                        "volumen" => "111"
                        "paginaInicial" => "676"
                        "paginaFinal" => "685"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9118708"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impact of appropriateness of initial antibiotic therapy on the outcome of ventilator-associated pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H Dupont"
                            1 => "H Mentec"
                            2 => "JP Sollet"
                            3 => "G Bleichner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2001"
                        "volumen" => "27"
                        "paginaInicial" => "355"
                        "paginaFinal" => "362"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11396279"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nosocomial pneumonia&#46; A multivariate analysis of risk and prognosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R Celis"
                            1 => "A Torres"
                            2 => "JM Gatell"
                            3 => "M Almela"
                            4 => "R Rodr&#237;guez-Roisin"
                            5 => "A Agust&#237;-Vidal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1988"
                        "volumen" => "93"
                        "paginaInicial" => "318"
                        "paginaFinal" => "324"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3338299"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence&#44; risk&#44; and prognosis factors of nosocomial pneumonia in mechanically ventilated patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A Torres"
                            1 => "R Aznar"
                            2 => "JM Gatell"
                            3 => "P Jim&#233;nez"
                            4 => "J Gonz&#225;lez"
                            5 => "A Ferrer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm/142.3.523"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Rev Respir Dis"
                        "fecha" => "1990"
                        "volumen" => "142"
                        "paginaInicial" => "523"
                        "paginaFinal" => "528"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2202245"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nosocomial pneumonia in ventilated patients&#58; a cohort study evaluating attributable mortality and hospital stay"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "JY Fagon"
                            1 => "J Chastre"
                            2 => "AJ Hance"
                            3 => "P Montravers"
                            4 => "A Novara"
                            5 => "C Gibert"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Med"
                        "fecha" => "1993"
                        "volumen" => "94"
                        "paginaInicial" => "281"
                        "paginaFinal" => "288"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8452152"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evidence-based assessment of diagnostic tests for ventilator-associated pneumonia&#46; Executive summary"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2000"
                        "volumen" => "117"
                        "paginaInicial" => "177S"
                        "paginaFinal" => "181S"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hospital-acquired pneumonia in adults&#58; diagnosis&#44; assessment of severity&#44; initial antimicrobial therapy&#44; and preventive strategies&#46; A consensus statement&#44; American Thoracic Society&#44; November 1995"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.153.5.8630626"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1996"
                        "volumen" => "153"
                        "paginaInicial" => "1711"
                        "paginaFinal" => "1725"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Normativas SEPAR&#46; Diagn&#243;stico y tratamiento de la neumon&#237;a nosocomial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "1997"
                        "volumen" => "33"
                        "paginaInicial" => "346"
                        "paginaFinal" => "350"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines for the initial management of adults with community-acquired pneumonia&#58; diagnosis&#44; assessment of severity&#44; and initial antimicrobial therapy&#46; American Thoracic Society&#46; Medical Section of the American Lung Association"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm/148.5.1418"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Rev Respir Dis"
                        "fecha" => "1993"
                        "volumen" => "148"
                        "paginaInicial" => "1418"
                        "paginaFinal" => "1426"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ventilator-associated pneumonia caused by potentially drug-resistant bacteria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.157.2.9705064"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1998"
                        "volumen" => "157"
                        "paginaInicial" => "531"
                        "paginaFinal" => "539"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ventilator-associated pneumonia&#46; European Task Force on ventilator-associated pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2001"
                        "volumen" => "17"
                        "paginaInicial" => "1034"
                        "paginaFinal" => "1045"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Initial bacterial colonization in patients admitted to a respiratory intensive care unit&#58; bacteriological pattern and risk factors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "50464"
                      "Revista" => array:6 [
                        "tituloSerie" => "Respiration"
                        "fecha" => "2001"
                        "volumen" => "68"
                        "paginaInicial" => "58"
                        "paginaFinal" => "66"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Variations in etiology of ventilator-associated pneumonia across four treatment sites&#58; implications for antimicrobial prescribing practices"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [ …5]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.160.2.9812034"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1999"
                        "volumen" => "160"
                        "paginaInicial" => "608"
                        "paginaFinal" => "613"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Severe community-acquired pneumonia in the elderly&#58; epidemiology and prognosis&#46; Study Group for Severe Community-Acquired Pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "1996"
                        "volumen" => "23"
                        "paginaInicial" => "723"
                        "paginaFinal" => "728"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Survival in patients with nosocomial pneumonia&#58; impact of the severity of illness and the etiologic agent"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "1997"
                        "volumen" => "25"
                        "paginaInicial" => "1862"
                        "paginaFinal" => "1867"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "International Conference for the Development of Consensus on the Diagnosis and Treatment of Ventilator-associated Pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2001"
                        "volumen" => "120"
                        "paginaInicial" => "955"
                        "paginaFinal" => "970"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prognosis and outcomes of patients with community-acquired pneumonia&#46; A meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "1996"
                        "volumen" => "275"
                        "paginaInicial" => "134"
                        "paginaFinal" => "141"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Reduced mortality of pneumococcal bacteremia after early intensive care"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Intensive Care"
                        "fecha" => "1994"
                        "volumen" => "6"
                        "paginaInicial" => "302"
                        "paginaFinal" => "307"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recomendaciones para el diagn&#243;stico de la neumon&#237;a asociada a ventilaci&#243;n mec&#225;nica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Enferm Infecc Microbiol Clin"
                        "fecha" => "2001"
                        "volumen" => "19"
                        "paginaInicial" => "479"
                        "paginaFinal" => "487"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prognostic factors of pneumonia requiring admission to the intensive care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [ …5]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1995"
                        "volumen" => "107"
                        "paginaInicial" => "511"
                        "paginaFinal" => "516"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Early onset pneumonia in neurosurgical intensive care unit patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Hosp Infect"
                        "fecha" => "1998"
                        "volumen" => "40"
                        "paginaInicial" => "275"
                        "paginaFinal" => "280"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nosocomial pneumonia in critically ill comatose patients&#58; need for a differential therapeutic approach"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "1992"
                        "volumen" => "5"
                        "paginaInicial" => "1249"
                        "paginaFinal" => "1253"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Aetiology of pneumonia following isolated closed head injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Respir Med"
                        "fecha" => "1997"
                        "volumen" => "91"
                        "paginaInicial" => "193"
                        "paginaFinal" => "199"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The attributable morbidity and mortality of ventilator-associated pneumonia in the critically ill patient&#46; The Canadian Critical Trials Group"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [ …5]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.159.4.9807050"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1999"
                        "volumen" => "159"
                        "paginaInicial" => "1249"
                        "paginaFinal" => "1256"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pneumonia&#58; incidence&#44; risk factors&#44; and outcome in injured patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Trauma"
                        "fecha" => "1991"
                        "volumen" => "31"
                        "paginaInicial" => "907"
                        "paginaFinal" => "912"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nosocomial pneumonia guidelines&#58;an international perspective"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1998"
                        "volumen" => "113"
                        "paginaInicial" => "188S"
                        "paginaFinal" => "193S"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of severe pneumonia in hospitalized patients&#58; results of a multicenter&#44; randomized&#44; double-blind trial comparing intravenous ciprofloxacin with imipenem-cilastatin&#46; The Severe Pneumonia Study Group"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Antimicrob Agents Chemother"
                        "fecha" => "1994"
                        "volumen" => "38"
                        "paginaInicial" => "547"
                        "paginaFinal" => "557"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Antimicrobial susceptibility of 1&#44;422 Haemophilus influenzae isolates from respiratory tract infections in Spain&#46; Results of a 1-year &#40;1996-97&#41; multicenter surveillance study&#46; Spanish Surveillance Group for Respiratory Pathogens"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Infection"
                        "fecha" => "1999"
                        "volumen" => "27"
                        "paginaInicial" => "265"
                        "paginaFinal" => "267"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib30"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "In vitro activity of newer fluoroquinolones for respiratory tract infections and emerging patterns of antimicrobial resistance&#58; data from the SENTRY antimicrobial surveillance program"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/314054"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "2000"
                        "volumen" => "31"
                        "paginaInicial" => "S16"
                        "paginaFinal" => "S23"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib31"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Levofloxacin compared with imipenem&#47;cilastatin followed by ciprofloxacin in adult patients with nosocomial pneumonia&#58; a multicenter&#44; prospective&#44; randomized&#44; open-label study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Ther"
                        "fecha" => "2003"
                        "volumen" => "25"
                        "paginaInicial" => "485"
                        "paginaFinal" => "506"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib32"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Empirical antimicrobial therapy of mechanically ventilated patients with nosocomial pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [ …1]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Antimicrob Chemother"
                        "fecha" => "1997"
                        "volumen" => "40"
                        "paginaInicial" => "463"
                        "paginaFinal" => "468"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib33"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prospective randomized comparison of imipenem monotherapy with imipenem plus netilmicin for treatment of severe infections in nonneutropenic patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Antimicrob Agents Chemother"
                        "fecha" => "1994"
                        "volumen" => "38"
                        "paginaInicial" => "1309"
                        "paginaFinal" => "1313"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib34"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outbreaks of Staphylococcus aureus infections during treatment of late onset pneumonia with ciprofloxacin in a prospective&#44; randomized study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "1998"
                        "volumen" => "24"
                        "paginaInicial" => "1327"
                        "paginaFinal" => "1330"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib35"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Antibiotic therapy for <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span> bacteremia&#58; outcome correlations in a prospective study of 200 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Med"
                        "fecha" => "1989"
                        "volumen" => "87"
                        "paginaInicial" => "540"
                        "paginaFinal" => "546"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib36"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prospective observational study of <span class="elsevierStyleItalic">Klebsiella bacteremia</span> in 230 patients&#58; outcome for antibiotic combinations versus monotherapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Antimicrob Agents Chemother"
                        "fecha" => "1992"
                        "volumen" => "36"
                        "paginaInicial" => "2639"
                        "paginaFinal" => "2644"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib37"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Monotherapy versus beta-lactam-aminoglycoside combination treatment for gram-negative bacteremia&#58; a prospective&#44; observational study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Antimicrob Agents Chemother"
                        "fecha" => "1997"
                        "volumen" => "41"
                        "paginaInicial" => "1127"
                        "paginaFinal" => "1133"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib38"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pathogens resistant to antimicrobial agents&#46; Epidemiology&#44; molecular mechanisms&#44; and clinical management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Infect Dis Clin North Am"
                        "fecha" => "1995"
                        "volumen" => "9"
                        "paginaInicial" => "497"
                        "paginaFinal" => "530"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib39"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Development of quinolone-imipenem cross resistance in <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span> during exposure to ciprofloxacin"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Antimicrob Agents Chemother"
                        "fecha" => "1990"
                        "volumen" => "34"
                        "paginaInicial" => "2142"
                        "paginaFinal" => "2147"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib40"
              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Meta-analyses are no longer required for determining the efficacy of single daily dosing of aminoglycosides"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [ …1]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "1997"
                        "volumen" => "24"
                        "paginaInicial" => "816"
                        "paginaFinal" => "819"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib41"
              "etiqueta" => "41"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Single or multiple daily doses of aminoglycosides&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "1996"
                        "volumen" => "312"
                        "paginaInicial" => "338"
                        "paginaFinal" => "345"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            41 => array:3 [
              "identificador" => "bib42"
              "etiqueta" => "42"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Continuous infusion versus intermittent administration of ceftazidime in critically ill patients with suspected gram-negative infections"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Antimicrob Agents Chemother"
                        "fecha" => "1996"
                        "volumen" => "40"
                        "paginaInicial" => "691"
                        "paginaFinal" => "695"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            42 => array:3 [
              "identificador" => "bib43"
              "etiqueta" => "43"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pharmacokinetic&#47;pharmacodynamic parameters&#58; rationale for antibacterial dosing of mice and men"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [ …1]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "1998"
                        "volumen" => "26"
                        "paginaInicial" => "1"
                        "paginaFinal" => "10"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            43 => array:3 [
              "identificador" => "bib44"
              "etiqueta" => "44"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efficacy of aerosolized tobramycin in patients with cystic fibrosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM199306173282403"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1993"
                        "volumen" => "328"
                        "paginaInicial" => "1740"
                        "paginaFinal" => "1746"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            44 => array:3 [
              "identificador" => "bib45"
              "etiqueta" => "45"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Aerosolized antibiotics in mechanically ventilated patients&#58; delivery and response"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [ …5]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "1998"
                        "volumen" => "26"
                        "paginaInicial" => "31"
                        "paginaFinal" => "39"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            45 => array:3 [
              "identificador" => "bib46"
              "etiqueta" => "46"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Endotracheal and aerosol administrations of ceftazidime in patients with nosocomial pneumonia&#58; pharmacokinetics and absolute bioavailability"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Antimicrob Agents Chemother"
                        "fecha" => "1992"
                        "volumen" => "36"
                        "paginaInicial" => "1404"
                        "paginaFinal" => "1411"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            46 => array:3 [
              "identificador" => "bib47"
              "etiqueta" => "47"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Linezolid vs vancomycin&#58; analysis of 2 double-blind studies of patients with methicillin-resistant <span class="elsevierStyleItalic">Staphylococcus aureus</span> nosocomial pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [ …5]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2003"
                        "volumen" => "124"
                        "paginaInicial" => "1789"
                        "paginaFinal" => "1797"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            47 => array:3 [
              "identificador" => "bib48"
              "etiqueta" => "48"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of 8 versus 15 days of antibiotic therapy for ventilator-associated pneumonia in adults&#58; a randomized trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.290.19.2588"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2003"
                        "volumen" => "290"
                        "paginaInicial" => "2588"
                        "paginaFinal" => "2598"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            48 => array:3 [
              "identificador" => "bib49"
              "etiqueta" => "49"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio nacional de vigilancia de infecci&#243;n nosocomial en unidades de cuidados intensivos&#46; Informe del a&#241;o 2001"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Intensiva"
                        "fecha" => "2003"
                        "volumen" => "27"
                        "paginaInicial" => "13"
                        "paginaFinal" => "23"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            49 => array:3 [
              "identificador" => "bib50"
              "etiqueta" => "50"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "El alto nivel de resistencia a los carbapenems en <span class="elsevierStyleItalic">Acinetobacter baumannii</span> es un problema multifactorial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [ …1]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Enferm Infecc Microbiol Clin"
                        "fecha" => "2001"
                        "volumen" => "19"
                        "paginaInicial" => "336"
                        "paginaFinal" => "338"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            50 => array:3 [
              "identificador" => "bib51"
              "etiqueta" => "51"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of multidrug-resistant <span class="elsevierStyleItalic">Acinetobacter baumanii</span> ventilator-associated penumonia &#40;VAP&#41; with intravenous colistin"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/374337"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "2003"
                        "volumen" => "36"
                        "paginaInicial" => "1111"
                        "paginaFinal" => "1118"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            51 => array:3 [
              "identificador" => "bib52"
              "etiqueta" => "52"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efficacy of colistin versus beta-lactams&#44; aminoglycosides&#44; and rifampin as monotherapy in a mouse model of pneumonia caused by multiresistant <span class="elsevierStyleItalic">Acinetobacter baumannii&#46;</span>"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Antimicrob Agents Chemother"
                        "fecha" => "2002"
                        "volumen" => "46"
                        "paginaInicial" => "1946"
                        "paginaFinal" => "1952"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            52 => array:3 [
              "identificador" => "bib53"
              "etiqueta" => "53"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "titulo" => "National Nosocomial Infections Surveillance &#40;NNIS&#41; report&#44; data summary from October 1986-April 1996&#44; issued May 1996&#46; A report from the National Nosocomial Infections Surveillance &#40;NNIS&#41; System"
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Infect Control"
                        "fecha" => "1996"
                        "volumen" => "24"
                        "paginaInicial" => "380"
                        "paginaFinal" => "388"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            53 => array:3 [
              "identificador" => "bib54"
              "etiqueta" => "54"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence of and risk factors for ventilator-associated pneumonia in critically ill patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "1998"
                        "volumen" => "129"
                        "paginaInicial" => "433"
                        "paginaFinal" => "440"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            54 => array:3 [
              "identificador" => "bib55"
              "etiqueta" => "55"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence&#44; risk&#44; and prognosis factors of nosocomial pneumonia in mechanically ventilated patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm/142.3.523"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Rev Respir Dis"
                        "fecha" => "1990"
                        "volumen" => "142"
                        "paginaInicial" => "523"
                        "paginaFinal" => "528"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            55 => array:3 [
              "identificador" => "bib56"
              "etiqueta" => "56"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mortality due to ventilator-associated pneumonia or colonization with <span class="elsevierStyleItalic">Pseudomonas or Acinetobacter species&#58;</span> assessment by quantitative culture of samples obtained by a protected specimen brush"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [ …5]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "1996"
                        "volumen" => "23"
                        "paginaInicial" => "538"
                        "paginaFinal" => "542"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            56 => array:3 [
              "identificador" => "bib57"
              "etiqueta" => "57"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ventilator-associated pneumonia due to <span class="elsevierStyleItalic">Pseudomonas aeruginosa&#46;</span>"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1996"
                        "volumen" => "109"
                        "paginaInicial" => "1019"
                        "paginaFinal" => "1029"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            57 => array:3 [
              "identificador" => "bib58"
              "etiqueta" => "58"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ventilator-associated pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.165.7.2105078"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2002"
                        "volumen" => "165"
                        "paginaInicial" => "867"
                        "paginaFinal" => "903"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            58 => array:3 [
              "identificador" => "bib59"
              "etiqueta" => "59"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Continuous versus intermittent administration of ceftazidime in intensive care unit patients with nosocomial pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [ …5]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Antimicrob Agents"
                        "fecha" => "2001"
                        "volumen" => "17"
                        "paginaInicial" => "497"
                        "paginaFinal" => "504"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            59 => array:3 [
              "identificador" => "bib60"
              "etiqueta" => "60"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Differential release of smooth-type lipopolysaccharide from <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span> treated with carbapenem antibiotics and its relation to production of tumor necrosis factor alpha and nitric oxide"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Antimicrob Agents Chemother"
                        "fecha" => "1996"
                        "volumen" => "40"
                        "paginaInicial" => "2410"
                        "paginaFinal" => "2412"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            60 => array:3 [
              "identificador" => "bib61"
              "etiqueta" => "61"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prospective randomized comparison of imipenem-cilastatin and piperacillin-tazobactam in nosocomial pneumonia or peritonitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Antimicrob Agents Chemother"
                        "fecha" => "1998"
                        "volumen" => "42"
                        "paginaInicial" => "2966"
                        "paginaFinal" => "2972"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            61 => array:3 [
              "identificador" => "bib62"
              "etiqueta" => "62"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of methodologies for synergism testing of drug combinations against resistant strains of <span class="elsevierStyleItalic">Pseudomonas aeruginosa&#46;</span>"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Antimicrob Agents Chemother"
                        "fecha" => "1996"
                        "volumen" => "40"
                        "paginaInicial" => "677"
                        "paginaFinal" => "683"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            62 => array:3 [
              "identificador" => "bib63"
              "etiqueta" => "63"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Role of aztreonam in the treatment of nosocomial pneumonia in the critically ill surgical patient"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [ …1]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Surg"
                        "fecha" => "2000"
                        "volumen" => "179"
                        "paginaInicial" => "45"
                        "paginaFinal" => "50"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            63 => array:3 [
              "identificador" => "bib64"
              "etiqueta" => "64"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Monotherapy of nosocomial pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Sem Resp Crit Care Med"
                        "fecha" => "2000"
                        "volumen" => "21"
                        "paginaInicial" => "9"
                        "paginaFinal" => "17"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            64 => array:3 [
              "identificador" => "bib65"
              "etiqueta" => "65"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of nosocomial pneumonia and tracheobronchitis caused by multidrug-resistant <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span> with aerosolized colistin"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [ …1]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.162.1.9910071"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2000"
                        "volumen" => "162"
                        "paginaInicial" => "328"
                        "paginaFinal" => "330"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            65 => array:3 [
              "identificador" => "bib66"
              "etiqueta" => "66"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The role of nebulized antibiotics in treating serious respiratory infections"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [ …1]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1179/joc.2001.13.4.354"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Chemother"
                        "fecha" => "2001"
                        "volumen" => "13"
                        "paginaInicial" => "354"
                        "paginaFinal" => "362"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            66 => array:3 [
              "identificador" => "bib67"
              "etiqueta" => "67"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Appropriate antibiotic treatment for pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/317439"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "2000"
                        "volumen" => "31"
                        "paginaInicial" => "1313"
                        "paginaFinal" => "1315"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            67 => array:3 [
              "identificador" => "bib68"
              "etiqueta" => "68"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of conventional dosing versus continuous-infusion vancomycin therapy for patients with suspected or documented gram-positive infections"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Antimicrob Agents Chemother"
                        "fecha" => "1996"
                        "volumen" => "40"
                        "paginaInicial" => "696"
                        "paginaFinal" => "700"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            68 => array:3 [
              "identificador" => "bib69"
              "etiqueta" => "69"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of inhaled vancomycin hydrochloride on elimination of methicillin-resistant <span class="elsevierStyleItalic">Staphylococcus aureus&#46;</span>"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Nihon Kyobu Shikkan Gakkai Zasshi"
                        "fecha" => "1995"
                        "volumen" => "33"
                        "paginaInicial" => "1233"
                        "paginaFinal" => "1239"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            69 => array:3 [
              "identificador" => "bib70"
              "etiqueta" => "70"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Inhaled vancomycin-induced allergic reaction in decontamination of respiratory tracts for allogeneic bone marrow transplantation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/sj.bmt.1701007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Bone Marrow Transplant"
                        "fecha" => "1997"
                        "volumen" => "20"
                        "paginaInicial" => "1001"
                        "paginaFinal" => "1003"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            70 => array:3 [
              "identificador" => "bib71"
              "etiqueta" => "71"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trimethoprim-sulfamethoxazole compared with vancomycin for the treatment of <span class="elsevierStyleItalic">Staphylococcus aureus</span> infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "1992"
                        "volumen" => "117"
                        "paginaInicial" => "390"
                        "paginaFinal" => "398"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            71 => array:3 [
              "identificador" => "bib72"
              "etiqueta" => "72"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "In vitro activity of fosfomycin&#44; alone and in combination&#44; against methicillin-resistant <span class="elsevierStyleItalic">Staphylococcus aureus&#46;</span>"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Antimicrob Agents Chemother"
                        "fecha" => "1985"
                        "volumen" => "28"
                        "paginaInicial" => "689"
                        "paginaFinal" => "690"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            72 => array:3 [
              "identificador" => "bib73"
              "etiqueta" => "73"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trimethoprim-sulfamethoxazole for the prevention of methicillin-resistant <span class="elsevierStyleItalic">Staphylococcus aureus</span> pneumonia in severely burned patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Trauma"
                        "fecha" => "1998"
                        "volumen" => "45"
                        "paginaInicial" => "383"
                        "paginaFinal" => "387"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            73 => array:3 [
              "identificador" => "bib74"
              "etiqueta" => "74"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "titulo" => "Quinupristin&#47;dalfopristin"
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Lett Drugs Ther"
                        "fecha" => "1999"
                        "volumen" => "41"
                        "paginaInicial" => "109"
                        "paginaFinal" => "110"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            74 => array:3 [
              "identificador" => "bib75"
              "etiqueta" => "75"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Interactions of quinupristin-dalfopristin with eight other antibiotics as measured by time-kill studies with 10 strains of <span class="elsevierStyleItalic">Staphylococcus aureus</span> for which quinupristin-dalfopristin alone was not bactericidal"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Antimicrob Agents Chemother"
                        "fecha" => "2001"
                        "volumen" => "45"
                        "paginaInicial" => "2662"
                        "paginaFinal" => "2665"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            75 => array:3 [
              "identificador" => "bib76"
              "etiqueta" => "76"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparative activity of linezolid and other new agents against methicillin-resistant <span class="elsevierStyleItalic">Staphylococcus aureus</span> and teicoplanin-intermediate coagulase-negative staphylococci"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Antimicrob Chemother"
                        "fecha" => "2001"
                        "volumen" => "48"
                        "paginaInicial" => "911"
                        "paginaFinal" => "913"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            76 => array:3 [
              "identificador" => "bib77"
              "etiqueta" => "77"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of gram-positive nosocomial pneumonia&#46; Prospective randomized comparison of quinupristin&#47;dalfopristin versus vancomycin&#46; Nosocomial Pneumonia Group"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.161.3.9904115"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2000"
                        "volumen" => "161"
                        "paginaInicial" => "753"
                        "paginaFinal" => "762"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            77 => array:3 [
              "identificador" => "bib78"
              "etiqueta" => "78"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Linezolid &#40;PNU-100766&#41; versus vancomycin in the treatment of hospitalized patients with nosocomial pneumonia&#58; a randomized&#44; double-blind&#44; multicenter study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/318486"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "2001"
                        "volumen" => "32"
                        "paginaInicial" => "402"
                        "paginaFinal" => "412"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            78 => array:3 [
              "identificador" => "bib79"
              "etiqueta" => "79"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Superinfection with <span class="elsevierStyleItalic">Enterococcus faecalis</span> during quinupristin&#47;dalfopristin therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "1997"
                        "volumen" => "24"
                        "paginaInicial" => "91"
                        "paginaFinal" => "92"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            79 => array:3 [
              "identificador" => "bib80"
              "etiqueta" => "80"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vancomycin and oxacillin synergy for methicillin-resistant staphylococci"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Antimicrob Agents Chemother"
                        "fecha" => "2000"
                        "volumen" => "44"
                        "paginaInicial" => "1394"
                        "paginaFinal" => "1396"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            80 => array:3 [
              "identificador" => "bib81"
              "etiqueta" => "81"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Combinations of vancomycin and beta-lactams are synergistic against staphylococci with reduced susceptibilities to vancomycin"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Antimicrob Agents Chemother"
                        "fecha" => "1999"
                        "volumen" => "43"
                        "paginaInicial" => "1747"
                        "paginaFinal" => "1753"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            81 => array:3 [
              "identificador" => "bib82"
              "etiqueta" => "82"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Combined effects of vancomycin and imipenem against methicillin-resistant <span class="elsevierStyleItalic">Staphylococcus aureus</span> &#40;MRSA&#41; in vitro and in vivo"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Antimicrob Chemother"
                        "fecha" => "1999"
                        "volumen" => "44"
                        "paginaInicial" => "455"
                        "paginaFinal" => "460"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0140673600040046"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            82 => array:3 [
              "identificador" => "bib83"
              "etiqueta" => "83"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "In vitro synergistic effects of double and triple combinations of betalactams&#44; vancomycin&#44; and netilmicin against methicillin-resistant <span class="elsevierStyleItalic">Staphylococcus aureus</span> strains"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Antimicrob Agents Chemother"
                        "fecha" => "2000"
                        "volumen" => "44"
                        "paginaInicial" => "3055"
                        "paginaFinal" => "3060"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            83 => array:3 [
              "identificador" => "bib84"
              "etiqueta" => "84"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Noninvasive versus invasive microbial investigation in ventilator-associated pneumonia&#58; evaluation of outcome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.162.1.9907090"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2000"
                        "volumen" => "162"
                        "paginaInicial" => "119"
                        "paginaFinal" => "125"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            84 => array:3 [
              "identificador" => "bib85"
              "etiqueta" => "85"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Causes of fever and pulmonary densities in patients with clinical manifestations of ventilator-associated pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1994"
                        "volumen" => "106"
                        "paginaInicial" => "221"
                        "paginaFinal" => "235"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            85 => array:3 [
              "identificador" => "bib86"
              "etiqueta" => "86"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnosis of nosocomial pneumonia in mechanically ventilated patients by the blind protected telescoping catheter"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "1993"
                        "volumen" => "19"
                        "paginaInicial" => "377"
                        "paginaFinal" => "382"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            86 => array:3 [
              "identificador" => "bib87"
              "etiqueta" => "87"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Shortcourse empiric antibiotic therapy for patients with pulmonary infiltrates in the intensive care unit&#46; A proposed solution for indiscriminate antibiotic prescription"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [ …5]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/rccm.201110-1864OC"
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2000"
                        "volumen" => "162&#58;505"
                        "paginaInicial" => "11"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            87 => array:3 [
              "identificador" => "bib88"
              "etiqueta" => "88"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnosis of ventilator-associated pneumonia by bacteriologic analysis of bronchoscopic and nonbronchoscopic &#8220;blind&#8221; bronchoalveolar lavage fluid"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm/143.5_Pt_1.1121"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Rev Respir Dis"
                        "fecha" => "1991"
                        "volumen" => "143"
                        "paginaInicial" => "1121"
                        "paginaFinal" => "1129"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            88 => array:3 [
              "identificador" => "bib89"
              "etiqueta" => "89"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Resolution of ventilator-associated pneumonia&#58; prospective evaluation of the clinical pulmonary infection score as an early clinical predictor of outcome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.CCM.0000055380.86458.1E"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2003"
                        "volumen" => "31"
                        "paginaInicial" => "676"
                        "paginaFinal" => "682"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            89 => array:3 [
              "identificador" => "bib90"
              "etiqueta" => "90"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ventilator-associated pneumonia&#46; Failure to respond to antibiotic therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [ …1]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Chest Med"
                        "fecha" => "1995"
                        "volumen" => "16"
                        "paginaInicial" => "173"
                        "paginaFinal" => "193"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            90 => array:3 [
              "identificador" => "bib91"
              "etiqueta" => "91"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bronchoscopy in nonresolving nosocomial pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [ …1]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2000"
                        "volumen" => "117"
                        "paginaInicial" => "212S"
                        "paginaFinal" => "218S"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            91 => array:3 [
              "identificador" => "bib92"
              "etiqueta" => "92"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The 10 most common questions about nonresolving pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Pulm Med"
                        "fecha" => "1995"
                        "volumen" => "2"
                        "paginaInicial" => "88"
                        "paginaFinal" => "97"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            92 => array:3 [
              "identificador" => "bib93"
              "etiqueta" => "93"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nonresolving or slowly resolving pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Chest Med"
                        "fecha" => "1999"
                        "volumen" => "20"
                        "paginaInicial" => "623"
                        "paginaFinal" => "651"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            93 => array:3 [
              "identificador" => "bib94"
              "etiqueta" => "94"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nonresolving pneumonia and mimics of pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Clin North Am"
                        "fecha" => "2001"
                        "volumen" => "85"
                        "paginaInicial" => "1511"
                        "paginaFinal" => "1530"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            94 => array:3 [
              "identificador" => "bib95"
              "etiqueta" => "95"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Resolution of infectious parameters after antimicrobial therapy in patients with ventilator-associated pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [ …5]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.163.6.2007020"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2001"
                        "volumen" => "163"
                        "paginaInicial" => "1371"
                        "paginaFinal" => "1375"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            95 => array:3 [
              "identificador" => "bib96"
              "etiqueta" => "96"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recurrent <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span> pneumonia in ventilated patients&#58; relapse or reinfection&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.157.3.9703014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1998"
                        "volumen" => "157"
                        "paginaInicial" => "912"
                        "paginaFinal" => "916"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            96 => array:3 [
              "identificador" => "bib97"
              "etiqueta" => "97"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recurrent <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span> pneumonia in an intensive care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1992"
                        "volumen" => "101"
                        "paginaInicial" => "194"
                        "paginaFinal" => "198"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            97 => array:3 [
              "identificador" => "bib98"
              "etiqueta" => "98"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Complications of nosocomial pneumonia in the surgical patient"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Surg"
                        "fecha" => "2000"
                        "volumen" => "179"
                        "paginaInicial" => "63"
                        "paginaFinal" => "68"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            98 => array:3 [
              "identificador" => "bib99"
              "etiqueta" => "99"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dec&#225;logo de normas para la utilizaci&#243;n de antibi&#243;ticos en pacientes cr&#237;ticos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Intensiva"
                        "fecha" => "2000"
                        "volumen" => "24"
                        "paginaInicial" => "69"
                        "paginaFinal" => "77"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            99 => array:3 [
              "identificador" => "bib100"
              "etiqueta" => "100"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A pharmacokinetic model-independent approach for estimating dose required to give desired steady-state trough concentrations of drug in plasma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [ …1]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pharmacokinet Biopharm"
                        "fecha" => "1980"
                        "volumen" => "8"
                        "paginaInicial" => "105"
                        "paginaFinal" => "110"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            100 => array:3 [
              "identificador" => "bib101"
              "etiqueta" => "101"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impacto de las resistencias bacterianas sobre la pol&#237;tica antibi&#243;tica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [ …1]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Intensiva"
                        "fecha" => "1998"
                        "volumen" => "22"
                        "paginaInicial" => "17"
                        "paginaFinal" => "23"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            101 => array:3 [
              "identificador" => "bib102"
              "etiqueta" => "102"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Emergence of resistant bacterial strains during treatment of infections in the respiratory tract"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Scand J Infect Dis Suppl"
                        "fecha" => "1986"
                        "volumen" => "49"
                        "paginaInicial" => "135"
                        "paginaFinal" => "139"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            102 => array:3 [
              "identificador" => "bib103"
              "etiqueta" => "103"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Emergence of resistance in gram-negative bacteria during therapy with expanded-spectrum cephalosporins"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Clin Microbiol"
                        "fecha" => "1987"
                        "volumen" => "6"
                        "paginaInicial" => "456"
                        "paginaFinal" => "459"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15792129/0000004000000011/v1_201305141823/S1579212906603674/v1_201305141823/en/main.assets"
  "Apartado" => null
  "PDF" => "https://static.elsevier.es/multimedia/15792129/0000004000000011/v1_201305141823/S1579212906603674/v1_201305141823/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906603674?idApp=UINPBA00003Z"
]
Share
Journal Information
Vol. 40. Issue 11.
Pages 518-533 (November 2004)
Share
Share
Download PDF
More article options
Vol. 40. Issue 11.
Pages 518-533 (November 2004)
Recommendations
Full text access
Recommendations for the Treatment of Severe Nosocomial Pneumonia
Visits
7183
R. Jordà Marcos
Corresponding author
uci@clinicarotger.es

Correspondence: Dr. R. Jordà Marcos. Unidad de Cuidados Intensivos. Clínica Rotger. Santiago Russiñol, 9. 07012 Palma de Mallorca. España
, A. Torres Martí, F.J. Ariza Cardenal, F. Álvarez Lerma, F. Barcenilla Gaite, the Expert Committee of the Working Group on Infectious Diseases of the Spanish Society of Intensive Care Medicine, Critical and Coronary Units (GTEI-SEMICYUC) *, the Assembly on Tuberculosis and Respiratory Infections of the Spanish Society of Pulmonology and Thoracic Surgery (TIR-SEPAR) , the Nosocomial Infection Study Group of the Spanish Society of Infectious Diseases and Clinical Microbiology (GEIH-SEIMC).
This item has received
Article information
Full text is only aviable in PDF
REFERENCES
[1]
F Álvarez Lerma.
Modification of empiric antibiotic treatment in patients with pneumonia acquired in the intensive care unit. ICU-Acquired Pneumonia Study Group.
Intensive Care Med, 22 (1996), pp. 387-394
[2]
CM Luna, P Vujacich, MS Niederman, C Vay, C Gherardi, J Matera, et al.
Impact of BAL data on the therapy and outcome of ventilator-associated pneumonia.
Chest, 111 (1997), pp. 676-685
[3]
H Dupont, H Mentec, JP Sollet, G Bleichner.
Impact of appropriateness of initial antibiotic therapy on the outcome of ventilator-associated pneumonia.
Intensive Care Med, 27 (2001), pp. 355-362
[4]
R Celis, A Torres, JM Gatell, M Almela, R Rodríguez-Roisin, A Agustí-Vidal.
Nosocomial pneumonia. A multivariate analysis of risk and prognosis.
Chest, 93 (1988), pp. 318-324
[5]
A Torres, R Aznar, JM Gatell, P Jiménez, J González, A Ferrer, et al.
Incidence, risk, and prognosis factors of nosocomial pneumonia in mechanically ventilated patients.
Am Rev Respir Dis, 142 (1990), pp. 523-528
[6]
JY Fagon, J Chastre, AJ Hance, P Montravers, A Novara, C Gibert.
Nosocomial pneumonia in ventilated patients: a cohort study evaluating attributable mortality and hospital stay.
Am J Med, 94 (1993), pp. 281-288
[7]
RF Grossman, A Fein.
Evidence-based assessment of diagnostic tests for ventilator-associated pneumonia. Executive summary.
Chest, 117 (2000), pp. 177S-181S
[8]
G Campbell, M Niederman, W Broughton, D Craven, A Fein, M Fink, et al.
Hospital-acquired pneumonia in adults: diagnosis, assessment of severity, initial antimicrobial therapy, and preventive strategies. A consensus statement, American Thoracic Society, November 1995.
Am J Respir Crit Care Med, 153 (1996), pp. 1711-1725
[9]
A Torres, MR de Celis, S Bello, J Blanquer, J Dorca, L Molinos, et al.
Normativas SEPAR. Diagnóstico y tratamiento de la neumonía nosocomial.
Arch Bronconeumol, 33 (1997), pp. 346-350
[10]
MS Niederman, JB Bass Jr, GD Campbell, AM Fein, RF Grossman, LA Mandell, et al.
Guidelines for the initial management of adults with community-acquired pneumonia: diagnosis, assessment of severity, and initial antimicrobial therapy. American Thoracic Society. Medical Section of the American Lung Association.
Am Rev Respir Dis, 148 (1993), pp. 1418-1426
[11]
JL Trouillet, J Chastre, A Vuagnat, ML Joly-Guillou, D Combaux, MC Dombret, et al.
Ventilator-associated pneumonia caused by potentially drug-resistant bacteria.
Am J Respir Crit Care Med, 157 (1998), pp. 531-539
[12]
A Torres, J Carlet.
Ventilator-associated pneumonia. European Task Force on ventilator-associated pneumonia.
Eur Respir J, 17 (2001), pp. 1034-1045
[13]
MB Drakulovic, TT Bauer, A Torres, J González, MJ Rodríguez, J Angrill.
Initial bacterial colonization in patients admitted to a respiratory intensive care unit: bacteriological pattern and risk factors.
Respiration, 68 (2001), pp. 58-66
[14]
J Rello, M Sa-Borges, H Correa, SR Leal, J Baraibar.
Variations in etiology of ventilator-associated pneumonia across four treatment sites: implications for antimicrobial prescribing practices.
Am J Respir Crit Care Med, 160 (1999), pp. 608-613
[15]
J Rello, R Rodríguez, P Jubert, B Álvarez.
Severe community-acquired pneumonia in the elderly: epidemiology and prognosis. Study Group for Severe Community-Acquired Pneumonia.
Clin Infect Dis, 23 (1996), pp. 723-728
[16]
J Rello, M Rue, P Jubert, G Muses, R Sonora, J Vallés, et al.
Survival in patients with nosocomial pneumonia: impact of the severity of illness and the etiologic agent.
Crit Care Med, 25 (1997), pp. 1862-1867
[17]
J Rello, JA Paiva, J Baraibar, F Barcenilla, M Bodi, D Castander, et al.
International Conference for the Development of Consensus on the Diagnosis and Treatment of Ventilator-associated Pneumonia.
Chest, 120 (2001), pp. 955-970
[18]
MJ Fine, MA Smith, CA Carson, SS Mutha, SS Sankey, LA Weissfeld, et al.
Prognosis and outcomes of patients with community-acquired pneumonia. A meta-analysis.
JAMA, 275 (1996), pp. 134-141
[19]
C Franklin, K Henrickson, M Wail.
Reduced mortality of pneumococcal bacteremia after early intensive care.
J Intensive Care, 6 (1994), pp. 302-307
[20]
F Álvarez-Lerma, A Torres, F Rodríguez de Castro.
Recomendaciones para el diagnóstico de la neumonía asociada a ventilación mecánica.
Enferm Infecc Microbiol Clin, 19 (2001), pp. 479-487
[21]
J Almirall, E Mesalles, J Klamburg, O Parra, A Agudo.
Prognostic factors of pneumonia requiring admission to the intensive care unit.
Chest, 107 (1995), pp. 511-516
[22]
Y Berrouane, I Daudenthun, B Riegel, MN Emery, G Martin, R Krivosic, et al.
Early onset pneumonia in neurosurgical intensive care unit patients.
J Hosp Infect, 40 (1998), pp. 275-280
[23]
J Rello, V Ausina, M Ricart, C Puzo, A Net, G Prats.
Nosocomial pneumonia in critically ill comatose patients: need for a differential therapeutic approach.
Eur Respir J, 5 (1992), pp. 1249-1253
[24]
A Cazzadori, G di Perri, S Vento, S Bonora, D Fendt, M Rossi, et al.
Aetiology of pneumonia following isolated closed head injury.
Respir Med, 91 (1997), pp. 193-199
[25]
DK Heyland, DJ Cook, L Griffith, SP Keenan, C Brun-Buisson.
The attributable morbidity and mortality of ventilator-associated pneumonia in the critically ill patient. The Canadian Critical Trials Group.
Am J Respir Crit Care Med, 159 (1999), pp. 1249-1256
[26]
JL Rodríguez, KJ Gibbons, LG Bitzer, RE Dechert, SM Steinberg, LM Flint.
Pneumonia: incidence, risk factors, and outcome in injured patients.
J Trauma, 31 (1991), pp. 907-912
[27]
LA Mandell, GD Campbell Jr.
Nosocomial pneumonia guidelines:an international perspective.
Chest, 113 (1998), pp. 188S-193S
[28]
MP Fink, DR Snydman, MS Niederman, KV Leeper Jr, RH Johnson, SO Heard, et al.
Treatment of severe pneumonia in hospitalized patients: results of a multicenter, randomized, double-blind trial comparing intravenous ciprofloxacin with imipenem-cilastatin. The Severe Pneumonia Study Group.
Antimicrob Agents Chemother, 38 (1994), pp. 547-557
[29]
JA García-Rodríguez, F Baquero, J García de Lomas, L Aguilar.
Antimicrobial susceptibility of 1,422 Haemophilus influenzae isolates from respiratory tract infections in Spain. Results of a 1-year (1996-97) multicenter surveillance study. Spanish Surveillance Group for Respiratory Pathogens.
Infection, 27 (1999), pp. 265-267
[30]
RN Jones, MA Pfaller.
In vitro activity of newer fluoroquinolones for respiratory tract infections and emerging patterns of antimicrobial resistance: data from the SENTRY antimicrobial surveillance program.
Clin Infect Dis, 31 (2000), pp. S16-S23
[31]
M West, BR Boulanger, C Fogarty, A Tennenberg, B Wiesinger, M Oross, et al.
Levofloxacin compared with imipenem/cilastatin followed by ciprofloxacin in adult patients with nosocomial pneumonia: a multicenter, prospective, randomized, open-label study.
Clin Ther, 25 (2003), pp. 485-506
[32]
EM Brown.
Empirical antimicrobial therapy of mechanically ventilated patients with nosocomial pneumonia.
J Antimicrob Chemother, 40 (1997), pp. 463-468
[33]
A Cometta, JD Baumgartner, D Lew, W Zimmerli, D Pittet, P Chopart, et al.
Prospective randomized comparison of imipenem monotherapy with imipenem plus netilmicin for treatment of severe infections in nonneutropenic patients.
Antimicrob Agents Chemother, 38 (1994), pp. 1309-1313
[34]
C Manhold, U von Rolbicki, R Brase, J Timm, E von Pritzbuer, M Heimesaat, et al.
Outbreaks of Staphylococcus aureus infections during treatment of late onset pneumonia with ciprofloxacin in a prospective, randomized study.
Intensive Care Med, 24 (1998), pp. 1327-1330
[35]
M Hilf, VL Yu, J Sharp, JJ Zuravleff, JA Korvick, RR Muder.
Antibiotic therapy for Pseudomonas aeruginosa bacteremia: outcome correlations in a prospective study of 200 patients.
Am J Med, 87 (1989), pp. 540-546
[36]
JA Korvick, CS Bryan, B Farber, TR Beam Jr, L Schenfeld, RR Muder, et al.
Prospective observational study of Klebsiella bacteremia in 230 patients: outcome for antibiotic combinations versus monotherapy.
Antimicrob Agents Chemother, 36 (1992), pp. 2639-2644
[37]
L Leibovici, M Paul, O Poznanski, M Drucker, Z Samra, H Konigsberger, et al.
Monotherapy versus beta-lactam-aminoglycoside combination treatment for gram-negative bacteremia: a prospective, observational study.
Antimicrob Agents Chemother, 41 (1997), pp. 1127-1133
[38]
HS Fraimow, E Abrutyn.
Pathogens resistant to antimicrobial agents. Epidemiology, molecular mechanisms, and clinical management.
Infect Dis Clin North Am, 9 (1995), pp. 497-530
[39]
G Radberg, LE Nilsson, S Svensson.
Development of quinolone-imipenem cross resistance in Pseudomonas aeruginosa during exposure to ciprofloxacin.
Antimicrob Agents Chemother, 34 (1990), pp. 2142-2147
[40]
DN Gilbert.
Meta-analyses are no longer required for determining the efficacy of single daily dosing of aminoglycosides.
Clin Infect Dis, 24 (1997), pp. 816-819
[41]
M Barza, JP Ioannidis, JC Cappelleri, J Lau.
Single or multiple daily doses of aminoglycosides: a meta-analysis.
BMJ, 312 (1996), pp. 338-345
[42]
AS Benko, DM Cappelletty, JA Kruse, MJ Rybak.
Continuous infusion versus intermittent administration of ceftazidime in critically ill patients with suspected gram-negative infections.
Antimicrob Agents Chemother, 40 (1996), pp. 691-695
[43]
WA Craig.
Pharmacokinetic/pharmacodynamic parameters: rationale for antibacterial dosing of mice and men.
Clin Infect Dis, 26 (1998), pp. 1-10
[44]
BW Ramsey, HL Dorkin, JD Eisenberg, RL Gibson, IR Harwood, RM Kravitz, et al.
Efficacy of aerosolized tobramycin in patients with cystic fibrosis.
N Engl J Med, 328 (1993), pp. 1740-1746
[45]
LB Palmer, GC Smaldone, SR Simon, TG O'Riordan, A Cuccia.
Aerosolized antibiotics in mechanically ventilated patients: delivery and response.
Crit Care Med, 26 (1998), pp. 31-39
[46]
F Bressolle, JE de la Coussaye, R Ayoub, D Fabre, R Gomeni, G Saissi, et al.
Endotracheal and aerosol administrations of ceftazidime in patients with nosocomial pneumonia: pharmacokinetics and absolute bioavailability.
Antimicrob Agents Chemother, 36 (1992), pp. 1404-1411
[47]
RG Wunderink, J Rello, SK Cammarata, RV Croos-Dabrera, MH Kollef.
Linezolid vs vancomycin: analysis of 2 double-blind studies of patients with methicillin-resistant Staphylococcus aureus nosocomial pneumonia.
Chest, 124 (2003), pp. 1789-1797
[48]
J Chastre, M Wolff, JY Fagon, S Chevret, F Thomas, D Wermert, et al.
Comparison of 8 versus 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial.
JAMA, 290 (2003), pp. 2588-2598
[49]
F Álvarez-Lerma, M Palomar, P Olaechea, J Insausti, B Bermejo, E Cerdá.
Estudio nacional de vigilancia de infección nosocomial en unidades de cuidados intensivos. Informe del año 2001.
Med Intensiva, 27 (2003), pp. 13-23
[50]
G Bou.
El alto nivel de resistencia a los carbapenems en Acinetobacter baumannii es un problema multifactorial.
Enferm Infecc Microbiol Clin, 19 (2001), pp. 336-338
[51]
J Garnacho-Montero, C Ortiz-Leyba, FJ Jiménez- Jiménez, AE Barrero-Almodóvar, JL García-Garmendia, M Bernabeu-Wittell, et al.
Treatment of multidrug-resistant Acinetobacter baumanii ventilator-associated penumonia (VAP) with intravenous colistin.
Clin Infect Dis, 36 (2003), pp. 1111-1118
[52]
A Montero, J Ariza, X Corbella, A Domenech, C Cabellos, J Ayats, et al.
Efficacy of colistin versus beta-lactams, aminoglycosides, and rifampin as monotherapy in a mouse model of pneumonia caused by multiresistant Acinetobacter baumannii..
Antimicrob Agents Chemother, 46 (2002), pp. 1946-1952
[53]
National Nosocomial Infections Surveillance (NNIS) report, data summary from October 1986-April 1996, issued May 1996. A report from the National Nosocomial Infections Surveillance (NNIS) System.
Am J Infect Control, 24 (1996), pp. 380-388
[54]
DJ Cook, SD Walter, RJ Cook, LE Griffith, GH Guyatt, D Leasa, et al.
Incidence of and risk factors for ventilator-associated pneumonia in critically ill patients.
Ann Intern Med, 129 (1998), pp. 433-440
[55]
A Torres, R Aznar, JM Gatell, P Jiménez, J González, A Ferrer, et al.
Incidence, risk, and prognosis factors of nosocomial pneumonia in mechanically ventilated patients.
Am Rev Respir Dis, 142 (1990), pp. 523-528
[56]
JY Fagon, J Chastre, Y Domart, JL Trouillet, C Gibert.
Mortality due to ventilator-associated pneumonia or colonization with Pseudomonas or Acinetobacter species: assessment by quantitative culture of samples obtained by a protected specimen brush.
Clin Infect Dis, 23 (1996), pp. 538-542
[57]
S Crouch Brewer, RG Wunderink, CB Jones, KV Leeper Jr.
Ventilator-associated pneumonia due to Pseudomonas aeruginosa..
Chest, 109 (1996), pp. 1019-1029
[58]
J Chastre, JY Fagon.
Ventilator-associated pneumonia.
Am J Respir Crit Care Med, 165 (2002), pp. 867-903
[59]
DP Nicolau, J McNabb, MK Lacy, R Quintiliani, CH Nightingale.
Continuous versus intermittent administration of ceftazidime in intensive care unit patients with nosocomial pneumonia.
Int J Antimicrob Agents, 17 (2001), pp. 497-504
[60]
T Yokochi, A Kusumi, N Kido, Y Kato, T Sugiyama, N Koide, et al.
Differential release of smooth-type lipopolysaccharide from Pseudomonas aeruginosa treated with carbapenem antibiotics and its relation to production of tumor necrosis factor alpha and nitric oxide.
Antimicrob Agents Chemother, 40 (1996), pp. 2410-2412
[61]
C Jaccard, N Troillet, S Harbarth, G Zanetti, D Aymon, R Schneider, et al.
Prospective randomized comparison of imipenem-cilastatin and piperacillin-tazobactam in nosocomial pneumonia or peritonitis.
Antimicrob Agents Chemother, 42 (1998), pp. 2966-2972
[62]
DM Cappelletty, MJ Rybak.
Comparison of methodologies for synergism testing of drug combinations against resistant strains of Pseudomonas aeruginosa..
Antimicrob Agents Chemother, 40 (1996), pp. 677-683
[63]
BA Boucher.
Role of aztreonam in the treatment of nosocomial pneumonia in the critically ill surgical patient.
Am J Surg, 179 (2000), pp. 45-50
[64]
H Lode, M Raffenberg, H Geerdes-Fenge.
Monotherapy of nosocomial pneumonia.
Sem Resp Crit Care Med, 21 (2000), pp. 9-17
[65]
DH Hamer.
Treatment of nosocomial pneumonia and tracheobronchitis caused by multidrug-resistant Pseudomonas aeruginosa with aerosolized colistin.
Am J Respir Crit Care Med, 162 (2000), pp. 328-330
[66]
PJ Cole.
The role of nebulized antibiotics in treating serious respiratory infections.
J Chemother, 13 (2001), pp. 354-362
[67]
J Rello, E Díaz, M Bodi.
Appropriate antibiotic treatment for pneumonia.
Clin Infect Dis, 31 (2000), pp. 1313-1315
[68]
JK James, SM Palmer, DP Levine, MJ Rybak.
Comparison of conventional dosing versus continuous-infusion vancomycin therapy for patients with suspected or documented gram-positive infections.
Antimicrob Agents Chemother, 40 (1996), pp. 696-700
[69]
M Shirai, K Ide, M Sato, M Murakami, Y Tanaka, A Sato, et al.
Effect of inhaled vancomycin hydrochloride on elimination of methicillin-resistant Staphylococcus aureus..
Nihon Kyobu Shikkan Gakkai Zasshi, 33 (1995), pp. 1233-1239
[70]
K Kahata, S Hashino, M Imamura, A Mori, S Kobayashi, M Asaka.
Inhaled vancomycin-induced allergic reaction in decontamination of respiratory tracts for allogeneic bone marrow transplantation.
Bone Marrow Transplant, 20 (1997), pp. 1001-1003
[71]
N Markowitz, EL Quinn, LD Saravolatz.
Trimethoprim-sulfamethoxazole compared with vancomycin for the treatment of Staphylococcus aureus infection.
Ann Intern Med, 117 (1992), pp. 390-398
[72]
S Álvarez, M Jones, SL Berk.
In vitro activity of fosfomycin, alone and in combination, against methicillin-resistant Staphylococcus aureus..
Antimicrob Agents Chemother, 28 (1985), pp. 689-690
[73]
A Kimura, T Mochizuki, K Nishizawa, K Mashiko, Y Yamamoto, T Otsuka.
Trimethoprim-sulfamethoxazole for the prevention of methicillin-resistant Staphylococcus aureus pneumonia in severely burned patients.
J Trauma, 45 (1998), pp. 383-387
[74]
Quinupristin/dalfopristin.
Med Lett Drugs Ther, 41 (1999), pp. 109-110
[75]
PC Fuchs, AL Barry, SD Brown.
Interactions of quinupristin-dalfopristin with eight other antibiotics as measured by time-kill studies with 10 strains of Staphylococcus aureus for which quinupristin-dalfopristin alone was not bactericidal.
Antimicrob Agents Chemother, 45 (2001), pp. 2662-2665
[76]
C Betriu, M Redondo, A Boloix, M Gómez, E Culebras, JJ Picazo.
Comparative activity of linezolid and other new agents against methicillin-resistant Staphylococcus aureus and teicoplanin-intermediate coagulase-negative staphylococci.
J Antimicrob Chemother, 48 (2001), pp. 911-913
[77]
J Fagon, H Patrick, DW Haas, A Torres, C Gibert, WG Cheadle, et al.
Treatment of gram-positive nosocomial pneumonia. Prospective randomized comparison of quinupristin/dalfopristin versus vancomycin. Nosocomial Pneumonia Group.
Am J Respir Crit Care Med, 161 (2000), pp. 753-762
[78]
E Rubinstein, S Cammarata, T Oliphant, R Wunderink.
Linezolid (PNU-100766) versus vancomycin in the treatment of hospitalized patients with nosocomial pneumonia: a randomized, double-blind, multicenter study.
Clin Infect Dis, 32 (2001), pp. 402-412
[79]
JW Chow, A Davidson, Sanford E 3rd, MJ Zervos.
Superinfection with Enterococcus faecalis during quinupristin/dalfopristin therapy.
Clin Infect Dis, 24 (1997), pp. 91-92
[80]
BE Domaracki, AM Evans, RA Venezia.
Vancomycin and oxacillin synergy for methicillin-resistant staphylococci.
Antimicrob Agents Chemother, 44 (2000), pp. 1394-1396
[81]
MW Climo, RL Patron, GL Archer.
Combinations of vancomycin and beta-lactams are synergistic against staphylococci with reduced susceptibilities to vancomycin.
Antimicrob Agents Chemother, 43 (1999), pp. 1747-1753
[82]
K Totsuka, M Shiseki, K Kikuchi, Y Matsui.
Combined effects of vancomycin and imipenem against methicillin-resistant Staphylococcus aureus (MRSA) in vitro and in vivo.
J Antimicrob Chemother, 44 (1999), pp. 455-460
[83]
S Rochon-Edouard, M Pestel-Caron, JF Lemeland, F Caron.
In vitro synergistic effects of double and triple combinations of betalactams, vancomycin, and netilmicin against methicillin-resistant Staphylococcus aureus strains.
Antimicrob Agents Chemother, 44 (2000), pp. 3055-3060
[84]
M Ruiz, A Torres, S Ewig, MA Marcos, A Alcon, R Lledo, et al.
Noninvasive versus invasive microbial investigation in ventilator-associated pneumonia: evaluation of outcome.
Am J Respir Crit Care Med, 162 (2000), pp. 119-125
[85]
GU Meduri, GL Mauldin, RG Wunderink, KV Leeper Jr, CB Jones, E Tolley, et al.
Causes of fever and pulmonary densities in patients with clinical manifestations of ventilator-associated pneumonia.
Chest, 106 (1994), pp. 221-235
[86]
R Jordà, F Parras, J Ibáñez, J Reina, J Bergada, JM Raurich.
Diagnosis of nosocomial pneumonia in mechanically ventilated patients by the blind protected telescoping catheter.
Intensive Care Med, 19 (1993), pp. 377-382
[87]
N Singh, P Rogers, CW Atwood, MM Wagener, VL Yu.
Shortcourse empiric antibiotic therapy for patients with pulmonary infiltrates in the intensive care unit. A proposed solution for indiscriminate antibiotic prescription.
Am J Respir Crit Care Med, 162:505 (2000), pp. 11
[88]
J Pugin, R Auckenthaler, N Mili, JP Janssens, PD Lew, PM Suter.
Diagnosis of ventilator-associated pneumonia by bacteriologic analysis of bronchoscopic and nonbronchoscopic “blind” bronchoalveolar lavage fluid.
Am Rev Respir Dis, 143 (1991), pp. 1121-1129
[89]
CM Luna, D Blanzaco, MS Niederman, W Matarucco, NC Baredes, P Desmery, et al.
Resolution of ventilator-associated pneumonia: prospective evaluation of the clinical pulmonary infection score as an early clinical predictor of outcome.
Crit Care Med, 31 (2003), pp. 676-682
[90]
RG Wunderink.
Ventilator-associated pneumonia. Failure to respond to antibiotic therapy.
Clin Chest Med, 16 (1995), pp. 173-193
[91]
MS Niederman.
Bronchoscopy in nonresolving nosocomial pneumonia.
Chest, 117 (2000), pp. 212S-218S
[92]
S Lowenkron, A Fein.
The 10 most common questions about nonresolving pneumonia.
Clin Pulm Med, 2 (1995), pp. 88-97
[93]
T Kuru, Lynch JP 3rd.
Nonresolving or slowly resolving pneumonia.
Clin Chest Med, 20 (1999), pp. 623-651
[94]
L Rome, G Murali, M Lippmann.
Nonresolving pneumonia and mimics of pneumonia.
Med Clin North Am, 85 (2001), pp. 1511-1530
[95]
PJ Dennesen, AJ van der Ven, AG Kessels, G Ramsay, MJ Bonten.
Resolution of infectious parameters after antimicrobial therapy in patients with ventilator-associated pneumonia.
Am J Respir Crit Care Med, 163 (2001), pp. 1371-1375
[96]
J Rello, D Mariscal, F March, P Jubert, F Sánchez, J Vallés, et al.
Recurrent Pseudomonas aeruginosa pneumonia in ventilated patients: relapse or reinfection?.
Am J Respir Crit Care Med, 157 (1998), pp. 912-916
[97]
DR Silver, IL Cohen, PF Weinberg.
Recurrent Pseudomonas aeruginosa pneumonia in an intensive care unit.
Chest, 101 (1992), pp. 194-198
[98]
S Rowe, WG Cheadle.
Complications of nosocomial pneumonia in the surgical patient.
Am J Surg, 179 (2000), pp. 63-68
[99]
F Álvarez Lerma, M Palomar.
Decálogo de normas para la utilización de antibióticos en pacientes críticos.
Med Intensiva, 24 (2000), pp. 69-77
[100]
JT Slattery.
A pharmacokinetic model-independent approach for estimating dose required to give desired steady-state trough concentrations of drug in plasma.
J Pharmacokinet Biopharm, 8 (1980), pp. 105-110
[101]
F Álvarez Lerma.
Impacto de las resistencias bacterianas sobre la política antibiótica.
Med Intensiva, 22 (1998), pp. 17-23
[102]
J Kosmidis, G Koratzanis.
Emergence of resistant bacterial strains during treatment of infections in the respiratory tract.
Scand J Infect Dis Suppl, 49 (1986), pp. 135-139
[103]
DL Dworzack, MP Pugsley, CC Sanders, EA Horowitz.
Emergence of resistance in gram-negative bacteria during therapy with expanded-spectrum cephalosporins.
Eur J Clin Microbiol, 6 (1987), pp. 456-459

A list of the members of the expert committee is given at the end of this article. The Wyeth Farma laboratory in Spain facilitated task force work meetings

A complete Spanish version of this article was also published inMedicina Intensiva (Med Intensiva 2004;25[5]:262-78) and in Enfermedades Infecciosasy Microbiología Clínica (Enferm Infecc Microbiol Clin 2004;22[8]:471-85)

Copyright © 2004. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?