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(Chest. 2005;128:583S-591S.)
© 2005 American College of Chest Physicians

Ventilator-Associated Pneumonia*

Insights From Recent Clinical Trials

Andrew F. Shorr, MD, MPH, FCCP and Marin H. Kollef, MD

* From the Pulmonary Clinic (Dr. Shorr), Pulmonary and Critical Care Medicine Service Department of Medicine, Walter Reed Army Medical Center, Washington, DC; and Pulmonary and Critical Care Division (Dr. Kollef), Washington University School of Medicine, Barnes-Jewish Hospital, St. Louis, MO.

Correspondence to: Andrew F. Shorr, MD, MPH, FCCP, Pulmonary and Critical Care Medicine, Washington Hospital Center, Washington, DC; e-mail: afshorr{at}mail.dnamail.com

Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in the ICU and contributes disproportionately to both poor outcomes and the high cost of care in critically ill patients. While VAP has been the focus of extensive research, little consensus exists about methods for diagnosis, treatment, or prevention. Delays in initiating appropriate therapy, antibiotic resistance due to indiscriminate and prolonged use of broad-spectrum antibiotics, and treatment of patients with a low risk of VAP (based on clinical pulmonary infection scores) represent a sample of VAP-related issues that have been addressed in recent clinical trials. Educational programs for VAP prevention and other nonpharmacologic strategies aimed at eliminating VAP have also been explored in clinical investigations. This review highlights selected areas of new clinical research on VAP treatment and prevention in order to place their significance in context.

Key Words: antibiotic resistance • antibiotic therapy • ventilator-associated pneumonia






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Copyright © 2005 by the American College of Chest Physicians.