American Thoracic Society Documents

American Thoracic Society DocumentsGuidelines for the Management of Adults withHospital-acquired, Ventilator-associated, andHealthcare-associated PneumoniaThis official statement of the American Thoracic Society and the Infectious Diseases Society of America was approvedby the ATS Board of Directors, December2004and the IDSA Guideline Committee, October2004 CONTENTSE xecutive SummaryIntroductionMethodology Used to Prepare the GuidelineEpidemiologyIncidenceEtiologyMa jor Epidemiologic PointsPathogenesisMajor Points for PathogenesisModifiable Risk FactorsIntubation and Mechanical VentilationAspiration, Body Position, and Enteral FeedingModulation of Colonization: Oral Antiseptics and AntibioticsStress Bleeding Prophylaxis, Transfusion, and Glucose ControlMajor Points and Recommendations for ModifiableRisk FactorsDiagnostic TestingMajor Points and Recommendations for DiagnosisDiagnostic Strategies and ApproachesClinical StrategyBacteriologic StrategyRecommended Diagnostic StrategyMajor Points and Recommendations for ComparingDiagnostic StrategiesAntibiotic Treatment of Hospital-acquired PneumoniaGeneral ApproachInitial Empiric Antibiotic TherapyAppropriate Antibiotic Selection and Adequate DosingLocal Instillation and Aerosolized AntibioticsCombination versus MonotherapyDuration of TherapyMajor Points and Recommendations for OptimalAntibiotic TherapySpecific Antibiotic RegimensAntibiotic Heterogeneity and Antibiotic CyclingRespo

• Linezolid is an alternative to vancomycin, and uncon-firmed, preliminary data suggest it may have an advantage for proven VAP due to methicillin-resistant S. aureus. • Colistin should be considered as therapy for patients with VAP due to a carbapenem-resistant Acinetobacter species. • Aerosolized antibiotics may have value as ...

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