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Guidelines
HAP and VAP

HAP and VAP

Definitions

Pneumonia not incubating at the time of hospital admission and occurring 48 hours or more after admission

Pneumonia occurring greater than 48 hours after endotracheal intubation

Risk Factors

  • Recent antibiotic use (especially IV in the last 3 months)
  • Structural lung disease (i.e. bronchiectasis, cystic fibrosis, COPD)
  • Prior infection with Pseudomonas
  • Known colonization
  • Underlying structural lung disease
  • Immunosuppression
  • Recent antibiotic use (especially IV in the last 3 months)
  • Known colonization or prior isolation of MRSA
  • Gram positive cocci on sputum Gram stain
  • Recent influenza-like illness
  • Presence of empyema or necrotizing pneumonia
  • Injection drug use

Microbiology

Additional Information

Guideline originally sourced from Markham Stouffville Hospital and adapted by Joseph Brant Hospital

  • Kalil AC, Metersky ML, Klompas M, et al. Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis 2016; 63:e61.

  • Sinai Health System & UHN Antimicrobial Stewardship Program Ventilator-Associated Pneumonia Treatment Guidelines. March 2020. Accessed May 2020 from: www.antimicrobialstewardship.com/vap

  • Sinai Health System & UHN Antimicrobial Stewardship Program Hospital-Acquired Pneumonia Treatment Guidelines. (No Date). Accessed May 2020 from: www.antimicrobialstewardship.com/hap

  • The Johns Hopkins University (2020) John Hopkins ABX Guide (1.27) [Mobile App] Retrieved from: www.hopkinsguides.com

  • Antimicrobial Therapy Inc (2020) The Sanford Guide (4.2) [Mobile App] Retrieved from: www.sanfordguide.com/

Approved: May 2020