{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:43:41Z","timestamp":1765889021937,"version":"build-2065373602"},"reference-count":30,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T00:00:00Z","timestamp":1672272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>We report a Russian case of a 61-year-old male patient with confirmed COVID-19 infection who developed nosocomial pneumonia complicated by lung abscess associated with multi-drug-resistant isolates of Klebsiella pneumoniae and Acinetobacter baumannii, which could have been provoked due to the immunosuppressive therapy. We discuss the existing literature highlighting the issue of the prudent balance between benefits and risks when prescribing immunomodulators to hospitalized patients with COVID-19 due to the risk of difficult-to-treat nosocomial infections caused by MDR Gram-negative bacterial pathogens. Currently, there is evidence of a substantial positive effect of dexamethasone on the course of COVID-19 in patients requiring supplemental oxygen or anti-interleukin-6 drugs in individuals with prominent systemic inflammation. However, it seems that in real clinical practice, the proposed criteria for initiating treatment with immunomodulators are interpreted arbitrarily, and the doses of dexamethasone can significantly exceed those recommended.<\/jats:p>","DOI":"10.3390\/antibiotics12010053","type":"journal-article","created":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T02:56:50Z","timestamp":1672282610000},"page":"53","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Clinical Case of Nosocomial Pneumonia as a Complication of COVID-19: How to Balance Benefits and Risks of Immunosuppressive Therapy?"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3329-7846","authenticated-orcid":false,"given":"Svetlana","family":"Rachina","sequence":"first","affiliation":[{"name":"Internal Medicine Department #2, Sechenov First Moscow State Medical University, 119991 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8882-6143","authenticated-orcid":false,"given":"Gairat","family":"Kiyakbaev","sequence":"additional","affiliation":[{"name":"Internal Medicine Department #2, Sechenov First Moscow State Medical University, 119991 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Antonova","sequence":"additional","affiliation":[{"name":"War Veterans Hospital #3 of Moscow, 129336 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexey","family":"Mescheryakov","sequence":"additional","affiliation":[{"name":"War Veterans Hospital #3 of Moscow, 129336 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olga","family":"Kupryushina","sequence":"additional","affiliation":[{"name":"Internal Medicine Department #2, Sechenov First Moscow State Medical University, 119991 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Girindu","family":"Hewathanthirige","sequence":"additional","affiliation":[{"name":"Medical Faculty, Peoples\u2019 Friendship University of Russia, 117198 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9613-9717","authenticated-orcid":false,"given":"Ivan","family":"Palagin","sequence":"additional","affiliation":[{"name":"Institute of Antimicrobial Chemotherapy, Smolensk State Medical University, 214019 Smolensk, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1005-9212","authenticated-orcid":false,"given":"Elena","family":"Kozhevnikova","sequence":"additional","affiliation":[{"name":"War Veterans Hospital #3 of Moscow, 129336 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Sukhorukova","sequence":"additional","affiliation":[{"name":"N.N. Burdenko National Medical Research Center for Neurosurgery, 121087 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daria","family":"Strelkova","sequence":"additional","affiliation":[{"name":"Internal Medicine Department #2, Sechenov First Moscow State Medical University, 119991 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"535668","DOI":"10.3389\/fpubh.2020.535668","article-title":"Microbial Resistance Movements: An Overview of Global Public Health Threats Posed by Antimicrobial Resistance, and How Best to Counter","volume":"8","author":"Dhingra","year":"2020","journal-title":"Front. 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