• Marc J M Bonten.
• Department of Internal Medicine & Dermatology, Division of Internal Medicine & Infectious Diseases, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands. m.j.m.bonten@digd.azu.nl
• Curr Opin Crit Care. 2004 Oct 1; 10 (5): 364-8.

Purpose Of ReviewInfections remain an important threat for critically ill patients, and the emergence of antibiotic resistance is increasingly hampering successful treatment. In this review, new aspects of the diagnosis and prevention of ventilator-associated pneumonia and of strategies of antibiotic use to limit the development and spread of resistance are described.Recent FindingsPrevention of ventilator-associated pneumonia is cost effective, but the most optimal preventive measure (or set of measures) remains controversial. There is growing evidence that antibiotic prophylaxis reduces the occurrence of ventilator-associated pneumonia and improves patient outcome. Moreover, antibiotic use can be reduced by increasing the specificity of diagnosing ventilator-associated pneumonia and by limiting the duration of antibiotic treatment.SummaryRecent developments in diagnosis, treatment, and prevention of ventilator-associated pneumonia and strategies to reduce emergence of antibiotic resistance have been reviewed. Whether changes in antibiotic policy will reduce the emergence of antibiotic resistance remains to be determined. In this area, methodologic problems that have been overlooked in many studies have been addressed recently. These issues must be clarified to provide reliable data on the effects of interventions in hospital settings.Copyright 2004 Lippincott Williams & Wilkins

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