Management of Suspected Ventilator-Associated Pneumonia
Authors: James R. Johnson
Journal: Annals of Internal Medicine (2000)

Letters19 December 2000Management of Suspected Ventilator-Associated PneumoniaJames R. Johnson, MDJames R. Johnson, MDUniversity of Minnesota; Minneapolis Veterans Affairs Medical Center (Johnson)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-133-12-200012190-00019 SectionsAboutFull Text ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Fagon and colleagues' findings (1) suggest patients with suspected ventilator-associated pneumonia have better clinical outcomes when antibiotic therapy is individualized and tailored to cover only bacteria present in the lower respiratory tract in high concentrations than when therapy is instituted empirically according to a generic protocol and then adjusted to cover all bacterial isolates from tracheal secretions, regardless of concentration.This approach, which is consistent with traditional principles of infectious disease practice (2), increases the likelihood that true pathogens will be covered, while minimizing unnecessary antimicrobial therapy (1). However, how this information can best be translated into ...References1. Fagon JY, Chastre J, Wolff M, Gervais C, Parer-Aubas S, Stephan F, et al . Invasive and noninvasive strategies for management of suspected ventilator-associated pneumonia. A randomized trial. Ann Intern Med. 2000;132:621-30. LinkGoogle Scholar2. Bartlett JG, Breiman RF, Mandell LA, File TM. Community-acquired pneumonia in adults: guidelines for management. The Infectious Diseases Society of America. Clin Infect Dis. 1998;26:811-38. CrossrefMedlineGoogle Scholar3. Kollef MH, Bock KR, Richards RD, Hearns ML. The safety and diagnostic accuracy of minibronchoalveolar lavage in patients with suspected ventilator-associated pneumonia. Ann Intern Med. 1995;122:743-8. LinkGoogle Scholar4. Singh N, Rogers P, Atwood C, Yu VL. 36th Annual Meeting of the Infectious Diseases Society of America, Denver, CO, 12–15 November 1998. Alexandria, VA: Infectious Diseases Society of America; 1998:91. Google Scholar Author, Article, and Disclosure InformationAuthors: James R. Johnson, MDAffiliations: University of Minnesota; Minneapolis Veterans Affairs Medical Center (Johnson) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoInvasive and Noninvasive Strategies for Management of Suspected Ventilator-Associated Pneumonia Jean-Yves Fagon , Jean Chastre , Michel Wolff , Claude Gervais , Sylvie Parer-Aubas , François Stéphan , Thomas Similowski , Alain Mercat , Jean-Luc Diehl , Jean-Pierre Sollet , and Alain Tenaillon , for the VAP Trial Group*Management of Suspected Ventilator-Associated Pneumonia Santiago Ewig , Michael Niederman , and Antoni Torres Management of Suspected Ventilator-Associated Pneumonia Jean-Yves Fagon and Jean Chastre Metrics 19 December 2000Volume 133, Issue 12Page: 1008KeywordsAntibioticsAntimicrobialsAttentionBacteriaBacterial pneumoniaBronchoscopyInfectious diseasesPathogensRespiratory systemVentilator associated pneumonia ePublished: 19 December 2000 Issue Published: 19 December 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.Loading ...