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From “Pro and Con” Debate to Evidence-Based Practice : Ventilator-Associated Pneumonia

Bekele Afessa, MD, FCCP
Author and Funding Information

Affiliations: Rochester, MN
 ,  Dr. Afessa is Associate Professor of Medicine, Pulmonary and Critical Care Division, Mayo Clinic.

Correspondence to: Bekele Afessa, MD, FCCP, Division of Pulmonary and Critical Care Medicine, Mayo Clinic and Foundation, 200 First St SW, Rochester, MN 55905; e-mail: Afessa.Bekele@mayo.edu



Chest. 2004;125(5):1600-1602. doi:10.1378/chest.125.5.1600
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Ventilator-associated pneumonia (VAP) is responsible for approximately half of the infections acquired in the ICU.1 Patients with VAP have longer ICU and hospital length of stay, with higher crude hospital cost and mortality rate compared to patients without VAP.23 Despite the importance of VAP and its clinical and financial implications, the absence of a “gold standard” for its diagnosis and the scarcity of outcome-based clinical trials had led to “pro and con” debates, at times opinionated.45 Although the First International Consensus Conference on the Clinical Investigation of Ventilator-Associated Pneumonia highlighted the need for research in the field, most of its recommendations were based on expert opinions, not on scientific evidence.6 In this issue of CHEST (see page 1791), Micek et al shows that the duration of antibiotic therapy can be shortened by implementing clinical guidelines for discontinuing antibiotics.

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