Ventilator-Associated Pneumonia: No Antibiotics if Cultures Are Negative!

Ventilator-associated pneumonia (VAP) is a frequent complication — and a leading cause of morbidity and mortality — in mechanically ventilated, critically ill patients. Previous investigations have shown that prompt initiation of adequate antibiotic therapy can reduce VAP-associated mortality. Therefore, broad-spectrum antibiotics are regularly and readily prescribed by intensivists when VAP is suspected. This practice, however promotes emergence of resistant pathogens and development of Clostridium difficile–associated colitis. How to solve this dilemma?

In a recent retrospective cohort study involving patients with suspected VAP at a single hospital in Connecticut, researchers investigated the effects of promptly discontinuing empirical an…