Abstract
Ventilator-associated pneumonia (VAP) is a common complication occurring in critically
ill patients who are mechanically ventilated and is the leading cause of nosocomial
infection-related death. Etiologic agents for VAP widely differ based on the population
of intensive care unit patients, duration of hospital stay, and prior antimicrobial
therapy. VAP due to multidrug-resistant pathogens is associated with the highest morbidity
and mortality, likely due to delays in appropriate antimicrobial treatment. International
guidelines are currently available to guide diagnostic and therapeutic strategies.
VAP can be prevented through various pharmacological and non-pharmacological interventions,
which are more effective when grouped as bundles. When VAP is clinically suspected,
diagnostic strategies should include early collection of respiratory samples to guide
antimicrobial therapy. Empirical treatment should be based on the most likely etiologic
microorganisms and antibiotics likely to be active against these microorganisms. Response
to therapy should be reassessed after 3 to 5 days and antimicrobials adjusted or de-escalated
to reduce the burden of the disease. Finally, considering that drug resistance is
increasing worldwide, several novel antibiotics are being tested to efficiently treat
VAP in the coming decades.
Keywords
ventilator-associated pneumonia - hospital-acquired pneumonia - ventilator-associated
event - antibiotic - multidrug resistance - preventive bundle - diagnostic techniques
