Firstline - Clinical Decisions

Definition

Pneumonia that develops 48 hours or more after endotracheal intubation

Microbiological analyses (always order)

Probable Pathogens

Clinical Pearls

Choose All That Apply

Septic shock

Use of IV antibiotics in past 90 days

Immunosuppression

Chronic lung disease (e.g. bronchiectasis, cystic fibrosis)

Acute renal replacement therapy before VAP onset

Hospitalization for at least 5 days before VAP onset

Acute respiratory distress syndrome (ARDS) before VAP onset

Attribution

Guideline content derived from:

NB Provincial Health Authorities Anti-Infective Stewardship Committee. Antimicrobial Treatment of Ventilator-Associated Pneumonia (VAP). 09-2019.

References

Kalil AC 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. Clinical Infectious Diseases. 2016; 63: 1-51
Pugh R, Grant C, Cooke RP, Dempsey G. Short-course versus prolonged-course antibiotic therapy for hospital-acquired pneumonia in critically ill adults. Cochrane Database Syst Rev 2015; 8:Cd007577
Blondel-Hill E. & Fryters S. (2012). Bugs & Drugs. An Antimicrobial/Infectious Diseases Reference. Alberta Health Services.
MSH+UHN Antimicrobial Stewardship Program. Hospital Acquired Pneumonia. Accessed online 12-2016.
Management of Penicillin and Beta-Lactam Allergy. NB-ASC. 02-2016
Adult Antimicrobial Dosing Tool. NB-ASC. 11-2015