Short Courses of Antibiotics for Patients with Ventilator-Associated Pneumonia

Early, appropriate antibiotics are essential to successfully managing ventilator-associated pneumonia (VAP) in the intensive care unit (ICU). However, antibiotics often are continued past the guideline-recommended 7- to 8-day course.

Investigators from Thailand randomized 461 patients (median age, 64) with VAP to either individualized short courses of antibiotics (3–7 days) or usual care (≥8 days). VAP was diagnosed based on clinical and radiologic criteria. Patients in the short-course group were assessed daily for antibiotic discontinuation based on hemodynamic stability (i.e., no vasopressors) and absence of fever for 48 hours. When these criteria were met, antibiotics were discontinued as early as day 3 for patients with culture-negative…