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Journal of Pharmacy Practice, Vol. 18, No. 1, 53-62 (2005)
DOI: 10.1177/0897190004273475

Recent Trends in the Management of Ventilator-Associated Pneumonia

Stacy A. Voils, PharmD

Virginia Commonwealth University, Smith Building, Room 351, 410 North 12th Street, PO Box 980533, Richmond, VA 23298-0533

Keri S. Kim, PharmD

critical care pharmacy resident, Virginia Commonwealth University, Richmond

Eric T. Wittbrodt, PharmD, BCPS, FCCM

Philadelphia College of Pharmacy, University of the Sciences in Philadelphia

Ventilator-associated pneumonia (VAP) occurs frequently in mechanically ventilated patients and has a high mortality rate. To date, there is no consensus for the diagnosis of VAP. Effective reduction in VAP-inducedmortality requires amultifaceted approach to include assessment of individual risks for VAP, implementation of effective ventilator handling procedures, routine use of VAP prevention strategies, appropriate use and interpretation of invasive and noninvasive diagnostic tests, and early broad spectrum antibiotic coverage with narrowing of coverage and cessation of therapy based on clinical improvement. Pharmacokinetic and pharmacodynamic principlesmust be used in designingempiric antibiotic regimens. Because an inappropriate empiric regimen in VAP has been associated with increasedmortality, it is imperative to maintain intensive care unit–specific epidemiologic data.

Key Words: Ventilator-associated pneumonia • hospital-acquired pneumonia • bronchoalveolar lavage • Clinical Pulmonary Infection Score.


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