title: Optimizing antibiotic treatment for ventilator-associated pneumonia.
abstract: Ventilator-associated pneumonia (VAP) is the most common infectious complication in patients receiving mechanical ventilation and accounts for exorbitant use of resources in the intensive care unit. Antimicrobial management of VAP incorporates an initial broad-spectrum, empiric regimen to ensure appropriate coverage with deescalation of therapy after 48-72 hours based on culture results and sensitivities. When VAP clinically responds to treatment, antimicrobials should be discontinued after 7-8 days to reduce overall antibiotic consumption and the selection pressure on flora observed in the intensive care unit and thus minimize the development and spread of antimicrobial resistance.
authors.affiliation: Department of Pharmacy, Barnes-Jewish Hospital, St. Louis, Missouri 63110, USA. stm8241@bjc.org
authors.forename: Scott T
authors.initials: ST
authors.lastname: Micek
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Heuring
authors.forename: James M
authors.initials: JM
authors.lastname: Hollands
authors.forename: Rina A
authors.initials: RA
authors.lastname: Shah
authors.forename: Marin H
authors.initials: MH
authors.lastname: Kollef
mesh_terms: D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology* / Q000382:microbiology; D006801:Humans; D011014:Pneumonia / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology* / Q000382:microbiology; D012121:Respiration, Artificial / Q000009:adverse effects*; D012122:Ventilators, Mechanical / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents