New clinical practice guidelines from the Infectious Diseases Society of America (IDSA) and American Thoracic Society (ATS)  advise shorter antibiotics courses for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) - seven or fewer days of antibiotics, in a change from previous recommendations.

The guidelines recommend that hospitals develop an antibiogram, a regular analysis of the strains of bacteria causing pneumonia infections locally to ensure the optimal choice of antibiotics. The antibiogram should be specific to ICU patients and updated regularly, with the most appropriate frequency being determined by the hospital. The other differences with the 2005 guideline are the use of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology for the evaluation of evidence and removal of the concept of healthcare-associated pneumonia (HCAP).

The guidelines are published in the journal Clinical Infectious Diseases and were developed by a multidisciplinary panel that included infectious diseases, pulmonary and critical care specialists.

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Andre C. Kalil, MD, MPH, lead author of the guidelines, professor of medicine in the Division of Infectious Diseases and director of the Transplant Infectious Diseases Program at the University of Nebraska Medical Center, Omaha in a statement said that once clinicians are regularly updated on the bacteria involved, and sensitivities to specific antibiotics, they can choose the most effective treatment.

"This helps individualise care, ensuring patients will be treated with the correct antibiotic as soon as possible,” he added.

Source: Infectious Diseases Society of America (IDSA)
Image credits: IDSA (top); University of Nebraska Medical Center

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References:

 Kalil AC, Metersky ML, Klompas M, Muscedere J, Sweeney DA, Palmer LB, Napolitano LM, O'Grady NP, Bartlett JG, Carratalà J, El Solh AA, Ewig S, Fey PD, File TM Jr, Restrepo MI, Roberts JA, Waterer GW, Cruse P, Knight SL, Brozek JL (2016) Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis, Jul 14. pii: ciw353. [Epub ahead of print]

Supplemental material is available on the IDSA website.



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pneumonia, antibiotics, antibiograms, Infectious Diseases Society of America, clinical practice guidelines, 7 days of antibiotics, hospital-acquired pneumonia, ventilator-associated pneumonia, HAP, VAP New clinical practice guidelines from the Infectious Diseases Society of America (IDSA) and American Thoracic Society (ATS) advise shorter antibiotics courses for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) - seven or fewe