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Set a Short Course But Follow the Patient’s Course for Ventilator-Associated PneumoniaSet a Course for Ventilator-Associated Pneumonia

Michael Klompas, MD, MPH
Author and Funding Information

From the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute; and the Department of Medicine, Brigham and Women’s Hospital.

Correspondence to: Michael Klompas, MD, MPH, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 133 Brookline Ave, 6th Floor, Boston, MA 02215; e-mail: mklompas@partners.org


Financial/nonfinancial disclosures: The author has reported to CHEST the following conflicts of interest: Dr Klompas has received grant funding for ventilator-associated pneumonia (VAP) research from the Centers for Disease Control and Prevention and honoraria for lectures on VAP surveillance from Premier Healthcare Alliance.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(6):1745-1747. doi:10.1378/chest.13-1744
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Defining the optimal duration of antibiotics for patients with ventilator-associated pneumonia is controversial. The 1995 American Thoracic Society guidelines recommended 14 to 21 days for patients with multilobar disease or infection due to Pseudomonas or Acinetobacter.1 These recommendations were based on observational studies documenting high risk of treatment failure, relapse, and death in these populations. Treating patients for extended periods, however, selects for drug-resistant pathogens including Clostridium difficile, raises costs, and increases the risk for adverse drug events.2-6

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