title: Treatment of ventilator-associated pneumonia and ventilator-associated tracheobronchitis in the intensive care unit. A national survey of clinicians and pharmacists in Saudi Arabia.
abstract: OBJECTIVE
  To assess current practices of different healthcare providers for treating extensively drug-resistant (XDR)  Acinetobacter baumannii (AB) infections  in tertiary-care centers in Saudi Arabia.
  
  
  METHODS
  This cross-sectional study was performed in  tertiary-care centers of Saudi Arabia between March and June 2014. A questionnaire consisting of 3 parts (respondent characteristics; case scenarios on ventilator-associated pneumonia [VAP] and tracheobronchitis [VAT], and antibiotic choices in each scenario) was developed and sent electronically to participants in 34 centers across Saudi Arabia.
  
  
  RESULTS
  One-hundred and eighty-three respondents completed the survey. Most of the respondents (54.6%) preferred to use colistin-based combination therapy to treat VAP caused by XDR AB, and 62.8% chose to continue treatment for 2 weeks. Most of the participants (80%) chose to treat VAT caused by XDR AB with intravenous antibiotics. A significant percentage of intensive care unit (ICU) fellows (41.3%) and clinical pharmacists (35%) opted for 2 million units (mu) of colistin every 8 hours without a loading dose, whereas 60% of infectious disease consultants, 45.8% of ICU consultants, and 44.4% of infectious disease fellows preferred a 9 mu loading dose followed by 9 mu daily in divided doses. The responses for the scenarios were different among healthcare providers (p less than 0.0001).
  
  
  CONCLUSIONS
  Most of the respondents in our survey preferred to use colistin-based combination therapy and intravenous antibiotics to treat VAP and VAT caused by XDR AB. However, colistin dose and duration varied among the healthcare providers.
authors.affiliation: Alfaisal University, Riyadh, Kingdom of Saudi Arabia. E-mail. dr_awad_ksa@yahoo.com.
authors.forename: Awad
authors.initials: A
authors.lastname: Al-Omari
authors.forename: Masood
authors.initials: M
authors.lastname: Mohammed
authors.forename: Waleed
authors.initials: W
authors.lastname: Alhazzani
authors.forename: Hasan M
authors.initials: HM
authors.lastname: Al-Dorzi
authors.forename: Mohammed S
authors.initials: MS
authors.lastname: Belal
authors.forename: Ali O
authors.initials: AO
authors.lastname: Albshabshe
authors.forename: Maha F
authors.initials: MF
authors.lastname: Al-Subaie
authors.forename: Yaseen M
authors.initials: YM
authors.lastname: Arabi
mesh_terms: D001991:Bronchitis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007362:Intensive Care Units; D008505:Medical Staff, Hospital; D010595:Pharmacists; D053717:Pneumonia, Ventilator-Associated / Q000628:therapy*; D012121:Respiration, Artificial / Q000009:adverse effects*; D012529:Saudi Arabia; D011795:Surveys and Questionnaires; D014136:Tracheitis / Q000209:etiology / Q000628:therapy*