What are the IDSA/ATF recommendations for the diagnosis of hospital-acquired pneumonia (HAP)?

Updated: Apr 15, 2021
  • Author: Kartika Shetty, MD, FACP; Chief Editor: John L Brusch, MD, FACP  more...
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Answer

Answer

Below is a summary of the recommendations of the recent IDSA/ATF guidelines for the management of hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). [4]

Microbiologic approach to diagnosing hospital-acquired pneumonia

If at all possible, patients should not be treated empirically. Antibiotic choice should be based on culture of sputum that is noninvasively obtained—spontaneously or by induction of sputum via nasotracheal suctioning or endotracheal aspiration in a patient who has been intubated because of HAP. Blood cultures should always be obtained, since blood culture findings are positive in a significant minority of HAP cases.

When no respiratory secretions can be obtained and blood cultures are negative, bronchoalveolar lavage should be considered in patients who are not responding to initial antibiotic therapy. [24]


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