Management of Suspected Ventilator-Associated Pneumonia
Authors: Santiago Ewig
Journal: Annals of Internal Medicine (2000)

Letters19 December 2000Management of Suspected Ventilator-Associated PneumoniaSantiago Ewig, MD, Michael Niederman, MD, and Antoni Torres, MDSantiago Ewig, MDMedizinische Universitätsklinik und Poliklinik Bonn; 53105 Bonn, Germany (Ewig)Winthrop-University Hospital; Mineola, NY 11501 (Niederman)Hospital Clinic i Provincial, Universitat de Barcelona; E-08036 Barcelona, Spain (Torres)Search for more papers by this author, Michael Niederman, MDMedizinische Universitätsklinik und Poliklinik Bonn; 53105 Bonn, Germany (Ewig)Winthrop-University Hospital; Mineola, NY 11501 (Niederman)Hospital Clinic i Provincial, Universitat de Barcelona; E-08036 Barcelona, Spain (Torres)Search for more papers by this author, and Antoni Torres, MDMedizinische Universitätsklinik und Poliklinik Bonn; 53105 Bonn, Germany (Ewig)Winthrop-University Hospital; Mineola, NY 11501 (Niederman)Hospital Clinic i Provincial, Universitat de Barcelona; E-08036 Barcelona, Spain (Torres)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-133-12-200012190-00020 SectionsAboutFull Text ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Fagon and associates (1) conclude that the invasive management strategy for ventilator-associated pneumonia was significantly associated with reduced mortality at 14 days, earlier attenuation of organ dysfunction, and less antibiotic use. In our view, the study does not provide convincing evidence for any of the conclusions drawn.The protocol basically includes a comparison of quantitative and qualitative cultures but not of invasive or noninvasive diagnostic strategies. Therefore, the conclusion that bronchoscopic diagnostic approaches are superior to any clinical approach is not justified. Moreover, the comparison remains doubtful (if not unfair) in that one well-standardized (invasive) strategy is ...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. Fagon JY, Chastre J, Vuagnat A, Trouillet JL, Novara A, Gibert C. Nosocomial pneumonia and mortality among patients in intensive care units. JAMA. 1996;275:866-9. CrossrefMedlineGoogle Scholar3. Kollef MH, Silver P, Murphy DM, Trovillion E. The effect of late-onset ventilator-associated pneumonia in determining patient mortality. Chest. 1995;108:1655-62. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Santiago Ewig, MD; Michael Niederman, MD; Antoni Torres, MDAffiliations: Medizinische Universitätsklinik und Poliklinik Bonn; 53105 Bonn, Germany (Ewig)Winthrop-University Hospital; Mineola, NY 11501 (Niederman)Hospital Clinic i Provincial, Universitat de Barcelona; E-08036 Barcelona, Spain (Torres) 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 Jean-Yves Fagon and Jean Chastre Management of Suspected Ventilator-Associated Pneumonia James R. Johnson Metrics Cited byDesign of a scanning magnetic induction phase measurement system for respiratory monitoringVentilator-associated pneumoniaPrevention and management of ventilator-associated pneumoniaApproaches to suspected ventilator-associated pneumonia: relying on our own bias 19 December 2000Volume 133, Issue 12Page: 1008-1009KeywordsAntibioticsAntimicrobialsDeath ratesMortalityPatientsVentilator associated pneumonia ePublished: 19 December 2000 Issue Published: 19 December 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.Loading ...