Ventilator-Associated Pneumonia: The Importance of Initial Empiric Antibiotic Selection

Ventilator-associated pneumonia (VAP) often results in an increased risk of in-hospital death. Four studies reviewed in this article demonstrate improved clinical outcomes when a broad-spectrum antibiotic regimen is prescribed soon after the diagnosis of VAP. Initial selection of antibiotics should be based on patient characteristics, local drug resistance patterns, and the patient's prior exposure to specific classes of antibiotics. As culture results from respiratory specimens become available, they can be used to narrow the range of pathogens targeted by the original regimen.