title: Antibiotic treatment of ventilator-associated tracheobronchitis: to treat or not to treat?
abstract: OBJECTIVE
  To evaluate the data on antimicrobial therapy for ventilator-associated tracheobronchitis (VAT) to prevent ventilator-associated pneumonia (VAP), and its impact on patient outcomes.
  
  
  RESULTS
  Mechanically ventilated patients are at increased risk for tracheal colonization with bacterial pathogens that may progress to VAT and/or VAP. Previous studies suggest that 10-30% of patients with VAT progress to VAP, which results in increased morbidity but not mortality. Several natural history studies and small randomized controlled trials and a meta-analysis reported that appropriate, pre-emptive antibiotic treatment for VAT reduces VAP, duration of intubation and length of ICU stay.
  
  
  CONCLUSIONS
  This review focuses on diagnostic criteria for VAT and VAP, etiologic agents, rationale and benefits of initiating pre-emptive, appropriate antibiotic treatment for VAT to prevent VAP, improve patient outcomes and associated acute and chronic healthcare costs.
authors: aCenter for Infectious Diseases and Prevention bDepartment of Surgical Critical Care cPulmonary and Critical Care dTufts University School of Medicine ePublic Health Consultant in Epidemiology and Infection Prevention, Boston, Massachusetts, USA.
authors: Donald E
authors: DE
authors: Craven
authors: Jana
authors: J
authors: Hudcova
authors: Kathleen A
authors: KA
authors: Craven
authors: Caitlin
authors: C
authors: Scopa
authors: Yuxiu
authors: Y
authors: Lei
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001991:Bronchitis / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D003428:Cross Infection; D006801:Humans; D007249:Inflammation / Q000188:drug therapy* / Q000503:physiopathology; D007362:Intensive Care Units; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D053717:Pneumonia, Ventilator-Associated / Q000517:prevention & control*; D011379:Prognosis; D014136:Tracheitis / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D012122:Ventilators, Mechanical / Q000009:adverse effects* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents