Best Treatment for Ventilator-Associated Pneumonia

Using decision analysis, researchers have found that initial use of three antibiotics followed by diagnostic testing led to better survival, less antibiotic use, and lower costs in patients with ventilator-associated pneumonia. Their findings were reported in the November 1, 2003, issue of the American Journal of Respiratory and Critical Care Medicine.

Ventilator-associated pneumonia complicates the course of patients on mechanical ventilation in eight to 28% of patients. The disease has a mortality rate of 24-50% and lengthens the patient's stay in the intensive care unit (ICU) and hospital. In the past, diagnostic testing has not been shown to affect survival, because of the time it takes to get the correct antibiotic therapy. The researchers used a decision analysis model employing a hypothetical group of immune-competent critically ill patients who were on a mechanical ventilator for seven days. A number of strategies were generated that were associated with varied diagnostic results. Probability estimates were derived from a literature search of 111 articles on the illness.

The researchers were from the North Shore Hospital (Manhasset, NY, USA), New York University School of Medicine (NYU, USA), and the State University of New York at Stony Brook (USA).






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North Shore Hospital
NYU School of Medicine
State U of NY at Stony Brook