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Ventilator-associated pneumonia

Key sources
The following summarized guidelines for the evaluation and management of ventilator-associated pneumonia are prepared by our editorial team based on guidelines from the Infectious Diseases Society of America (IDSA/ATS 2016).


1.Diagnostic investigations

Sputum cultures: consider performing noninvasive sampling with semiquantitative cultures rather than invasive sampling or quantitative cultures to diagnose VAP.
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2.Medical management

Initiation of antibiotics: use clinical criteria alone, rather than using serum procalcitonin plus clinical criteria, to decide whether or not to initiate antibiotic therapy in patients with suspected ventilator-acquired pneumonia.

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  • Duration of treatment

  • Antibiotic dosing

  • Empiric antibiotic therapy

  • Empiric MRSA coverage

  • Empiric antipseudomonal coverage

  • Aminoglycosides

  • Colistin

3.Specific circumstances

Patients with ventilator-associated pneumonia due to carbapenem-resistant pathogens
Administer intravenous polymixins such as colistin or polymyxin B, in patients with hospital-acquired pneumonia/ventillator- asscociated pneumonia caused by a carbapenem-resistant pathogen that is sensitive only to polymyxins.
Consider administering adjunctive inhaled colistin.

More topics in this section

  • Patients with VAP due to MRSA

  • Patients with VAP due to P. aeruginosa

  • Patients with VAP due to ESBL organisms