Identification of reliable, reproducible, and precise end points for future studies of hospital-acquired and ventilator-associated pneumonia is of paramount importance for approval of new therapeutic agents. As required by the Code of Federal Regulations 21 CFR 314.126, the methods of assessment of a subject's response (ie, end points) must be well defined and reliable. The study protocol and r...

The United States Centers for Disease Control and Prevention replaced their longstanding ventilator-associated pneumonia (VAP) definitions with ventilator-associated event (VAE) definitions in 2013. Controversy abounds as to whether VAE definitions are potentially suitable to serve as quality indicators for ICUs. On the pro side, VAE definitions overcome many of the weaknesses of traditional VA...

Title: A comparison of microbiology and demographics among patients with healthcare-associated, hospital-acquired, and ventilator-associated pneumonia: a retrospective analysis of 1184 patients from a large, international study

PURPOSE OF REVIEW The increasing rate of ventilator-associated pneumonia (VAP) caused by multidrug-resistant pathogens warrants the development of new treatment strategies. Carefully engineered delivery systems are undergoing evaluation to test the hypothesis that aerosolized administration of antibiotics will provide high local concentrations and fast clearance, which in turn may improve effic...

OBJECTIVES The aim of this study was to compare the t > MICs of imipenem between administration by a 2 h infusion with a 0.5 h infusion. METHODS The study was a randomized three-way crossover in nine patients with ventilator-associated pneumonia. Each subject received imipenem in three regimens consecutively: (i) a 0.5 h infusion of 0.5 g every 6 h for 24 h; (ii) a 2 h infusion of 0.5 g every...

Barriers to the use of selective digestive decontamination include concerns about emergence of resistant organisms, over-estimation of current performance in preventing ventilator-associated pneumonia (VAP), alternative methods of preventing VAP, and misunderstanding of mechanisms of action. A definitive cluster-randomised trial should be undertaken that incorporates practitioner concerns and e...

Ventilator-associated pneumonia is a common illness in intensive care unit patients. The costs of management are increased when infection involves resistant organisms, as well as unnecessary and prolonged therapy. Efforts at accurate diagnosis, therapy and prevention can reduce the cost impact of this illness.

1 Clinical Fellow, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA 2 Assistant Professor, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA 3 Associate Professor, Departments of Surgery and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh...