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Consensus Conference |

International Conference for the Development of Consensus on the Diagnosis and Treatment of Ventilator-Associated Pneumonia*

Jordi Rello, MD, PhD (Chairman); Jose Artur Paiva, MD (Conference Secretary); Jorge Baraibar, MD; Fernando Barcenilla, MD; Maria Bodi, MD; David Castander, MD; Humberto Correa, MD; Emili Diaz, MD; Jose Garnacho, MD, PhD; Montserrat Llorio, MD; Margarida Rios, MD; Alejandro Rodriguez, MD; Jorge Solé-Violán, MD, PhD
Author and Funding Information

*From the Hospital Universitari Joan XXIII (Drs. Rello and Bodi); Universitat Rovira i Virgili, Tarragona, Spain; Hospital São João (Drs. Paiva and Rios), Faculdade de Medicina do Porto, Porto, Portugal; Hospital Italiano (Dr. Baraibar), Montevideo, Uruguay; Hospital Universitari Arnau de Vilanova (Dr. Barcenilla), Lleida, Spain; Hospital Santa Tecla (Dr. Castander), Tarragona, Spain; Hospital de Clinicas (Dr. Correa), Universidad de la Republica, Montevideo, Uruguay; Center Hospitalari i Cardiologic de Manresa (Dr. Diaz), Barcelona, Spain; Hospital Universitario Virgen del Rocio (Dr. Garnacho), Seville, Spain; Hospital Posadas (Dr. Llorio), Buenos Aires, Argentina; Sanatorio Parque

Correspondence to: Jordi Rello, MD, PhD, Critical Care Department, Hospital Universitari Joan XXIII, Carrer Dr. Mallafre Guasch, 4, E43007 Tarragona, Spain; e-mail: jrc@hj23.es



Chest. 2001;120(3):955-970. doi:10.1378/chest.120.3.955
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Ventilator-associated pneumonia (VAP) is an important health problem that still generates great controversy. A consensus conference attended by 12 researchers from Europe and Latin America was held to discuss strategies for the diagnosis and treatment of VAP. Commonly asked questions concerning VAP management were selected for discussion by the participating researchers. Possible answers to the questions were presented to the researchers, who then recorded their preferences anonymously. This was followed by open discussion when the results were known. In general, peers thought that early microbiological examinations are warranted and contribute to improving the use of antibiotherapy. Nevertheless, no consensus was reached regarding choices of antimicrobial agents or the optimal duration of therapy. Piperacillin/tazobactam was the preferred choice for empiric therapy, followed by a cephalosporin with antipseudomonal activity and a carbapenem. All the peers agreed that the pathogens causing VAP and multiresistance patterns in their ICUs were substantially different from those reported in studies in the United States. Pathogens and multiresistance patterns also varied from researcher to researcher inside the group. Consensus was reached on the importance of local epidemiology surveillance programs and on the need for customized empiric antimicrobial choices to respond to local patterns of pathogens and susceptibilities.

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