Management of Ventilator-Associated Pneumonia: Guidelines

Mark L Metersky; Andre C Kalil

doi:10.1016/j.idc.2023.12.004

Management of Ventilator-Associated Pneumonia: Guidelines

Infect Dis Clin North Am. 2024 Mar;38(1):87-101. doi: 10.1016/j.idc.2023.12.004.

Authors

Mark L Metersky¹, Andre C Kalil²

Affiliations

¹ Division of Pulmonary, Critical Care and Sleep Medicine, University of Connecticut School of Medicine, UConn Health, 263 Farmington Avenue, Farmington, CT 06030-1321, USA. Electronic address: Metersky@uchc.edu.
² Department of Internal Medicine, Division of Infectious Diseases, University of Nebraska Medical Center, 985400 Nebraska Medical Center, Omaha, NE 68198, USA.

PMID: 38280768
DOI: 10.1016/j.idc.2023.12.004

Abstract

Two recent major guidelines on diagnosis and treatment of ventilator-associated pneumonia (VAP) recommend consideration of local antibiotic resistance patterns and individual patient risks for resistant pathogens when formulating an initial empiric antibiotic regimen. One recommends against invasive diagnostic techniques with quantitative cultures to determine the cause of VAP; the other recommends either invasive or noninvasive techniques. Both guidelines recommend short-course therapy be used for most patients with VAP. Although neither guideline recommends use of procalcitonin as an adjunct to clinical judgment when diagnosing VAP, they differ with respect to use of serial procalcitonin to shorten the length of antibiotic treatment.

Keywords: Guideline; Hospital-acquired pneumonia; Nosocomial pneumonia; Ventilator-associated pneumonia.

Publication types

Review

MeSH terms

Anti-Bacterial Agents
Humans
Pneumonia, Ventilator-Associated* / diagnosis
Pneumonia, Ventilator-Associated* / drug therapy
Procalcitonin / therapeutic use

Substances

Procalcitonin
Anti-Bacterial Agents