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Ventilator-associated pneumonia

Guidelines

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). ...
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Diagnostic investigations

Sputum cultures: as per ATS/IDSA 2016 guidelines, consider performing noninvasive sampling with semiquantitative cultures rather than invasive sampling or quantitative cultures to diagnose VAP.
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Medical management

Initiation of antibiotics: as per ATS/IDSA 2016 guidelines, 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

Specific circumstances

Patients with VAP due to carbapenem-resistant pathogens
As per ATS/IDSA 2016 guidelines:
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.
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Consider administering adjunctive inhaled colistin.
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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