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International ERS/ESICM/ESCMID/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia

Antoni Torres, Michael S. Niederman, Jean Chastre, Santiago Ewig, Patricia Fernandez-Vandellos, Hakan Hanberger, Marin Kollef, Gianluigi Li Bassi, Carlos M. Luna, Ignacio Martin-Loeches, J. Artur Paiva, Robert C. Read, David Rigau, Jean François Timsit, Tobias Welte, Richard Wunderink
European Respiratory Journal 2017 50: 1700582; DOI: 10.1183/13993003.00582-2017
Antoni Torres
Dept of Pulmonology, Hospital Clínic de Barcelona, Universitat de Barcelona and IDIBAPS, CIBERES, Barcelona, SpainThese two authors contributed equally to this work
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  • For correspondence: atorres@ub.edu
Michael S. Niederman
Division of Pulmonary and Critical Care Medicine, Weill Cornell Medicine, New York, NY, USAThese two authors contributed equally to this work
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Jean Chastre
Réanimation Médicale, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
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Santiago Ewig
CAPNETZ Stiftung and Thorax Centre in the Ruhr Area, Dept of Respiratory Medicine and Infectious Diseases, Evangelic Hospital in Herne and Augusta Hospital in Bochum, Bochum, Germany
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Patricia Fernandez-Vandellos
IDIBAPS, CIBERES, Barcelona, Spain
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Hakan Hanberger
Dept of Clinical and Experimental Medicine, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
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Marin Kollef
Pulmonary and Critical Care Division, Washington University School of Medicine, St Louis, MO, USA
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Gianluigi Li Bassi
Dept of Pulmonology, Hospital Clínic de Barcelona, Universitat de Barcelona and IDIBAPS, CIBERES, Barcelona, Spain
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Carlos M. Luna
Hospital de Clínicas “José de San Martin”, Universidad de Buenos Aires, Ciudad de Buenos Aires, Argentina
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Ignacio Martin-Loeches
Dept of Clinical Medicine, Wellcome Trust – HRB Clinical Research Facility, St James's Hospital, Trinity College, Dublin, Ireland and CIBERES, Barcelona, Spain
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J. Artur Paiva
Emergency and Intensive Care Dept, Centro Hospitalar São João EPE and Dept of Medicine, University of Porto Medical School, Porto, Portugal
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Robert C. Read
Academic Unit of Clinical Experimental Sciences and NIHR Southampton Biomedical Research Unit, Faculty of Medicine, and Institute for Life Sciences, University of Southampton, Southampton, UK
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David Rigau
Iberoamerican Cochrane Centre, Barcelona, Spain
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Jean François Timsit
IAME, INSERM UMR 1137, Medical and Infectious Diseases Intensive Care Unit, Paris Diderot University and Bichat Hospital, Paris, France
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Tobias Welte
Dept of Respiratory Medicine, Medizinische Hoschschule Hannover, Hannover and German Centre of Lung Research (DZL), Germany
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Richard Wunderink
Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Abstract

The most recent European guidelines and task force reports on hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) were published almost 10 years ago. Since then, further randomised clinical trials of HAP and VAP have been conducted and new information has become available. Studies of epidemiology, diagnosis, empiric treatment, response to treatment, new antibiotics or new forms of antibiotic administration and disease prevention have changed old paradigms. In addition, important differences between approaches in Europe and the USA have become apparent.

The European Respiratory Society launched a project to develop new international guidelines for HAP and VAP. Other European societies, including the European Society of Intensive Care Medicine and the European Society of Clinical Microbiology and Infectious Diseases, were invited to participate and appointed their representatives. The Latin American Thoracic Association was also invited.

A total of 15 experts and two methodologists made up the panel. Three experts from the USA were also invited (Michael S. Niederman, Marin Kollef and Richard Wunderink).

Applying the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) methodology, the panel selected seven PICO (population–intervention–comparison–outcome) questions that generated a series of recommendations for HAP/VAP diagnosis, treatment and prevention.

Abstract

ERS/ESICM/ESCMID/ALAT evidence-based recommendations for HAP/VAP diagnosis, treatment and prevention http://ow.ly/dGhv30dAVoa

Footnotes

  • This article has supplementary material available from erj.ersjournals.com

  • This document was endorsed by the ERS Executive Committee, ESCMID and ALAT in July 2017, and by ESICM in August 2017.

  • The guidelines published by the European Respiratory Society (ERS) incorporate data obtained from a comprehensive and systematic literature review of the most recent studies available at the time. Health professionals are encouraged to take the guidelines into account in their clinical practice. However, the recommendations issued by this guideline may not be appropriate for use in all situations. It is the individual responsibility of health professionals to consult other sources of relevant information, to make appropriate and accurate decisions in consideration of each patient's health condition and in consultation with that patient and the patient's caregiver where appropriate and/or necessary, and to verify rules and regulations applicable to drugs and devices at the time of prescription.

  • Conflict of interest: D. Rigau acts as a methodologist for the European Respiratory Society. All other disclosures can be found alongside this article at erj.ersjournals.com

  • Received March 20, 2017.
  • Accepted June 13, 2017.
  • Copyright ©ERS 2017
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International ERS/ESICM/ESCMID/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia
Antoni Torres, Michael S. Niederman, Jean Chastre, Santiago Ewig, Patricia Fernandez-Vandellos, Hakan Hanberger, Marin Kollef, Gianluigi Li Bassi, Carlos M. Luna, Ignacio Martin-Loeches, J. Artur Paiva, Robert C. Read, David Rigau, Jean François Timsit, Tobias Welte, Richard Wunderink
European Respiratory Journal Sep 2017, 50 (3) 1700582; DOI: 10.1183/13993003.00582-2017

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International ERS/ESICM/ESCMID/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia
Antoni Torres, Michael S. Niederman, Jean Chastre, Santiago Ewig, Patricia Fernandez-Vandellos, Hakan Hanberger, Marin Kollef, Gianluigi Li Bassi, Carlos M. Luna, Ignacio Martin-Loeches, J. Artur Paiva, Robert C. Read, David Rigau, Jean François Timsit, Tobias Welte, Richard Wunderink
European Respiratory Journal Sep 2017, 50 (3) 1700582; DOI: 10.1183/13993003.00582-2017
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