Pneumonia is a serious complication of mechanical ventilation. Pneumonia oc
curs despite the best efforts at prevention. Multiple methods available to
prevent ventilator-associated pneumonia are reviewed, and ventilation-assoc
iated pneumonia (VAP) is divided into early versus late onset. The authors
discuss the organisms associated with each of these situations, the empiric
antibiotic choices, and specific issues related to antibiotic therapy such
as resistance, pharmcodynamics, tissue penetration, and types of modificat
ions necessary in empiric choice when the cause of VAP is identified.