International conference for the development of consensus on the diagnosisand treatment of ventilator-associated pneumonia

Ventilator-associated pneumonia (NAP) is an important health problem that s till generates great controversy. A consensus conference attended by 12 res earchers from Europe and Latin America was held to discuss strategies for t he diagnosis and treatment of NAP. Commonly asked questions concerning VAP management were selected for discussion by the participating researchers. P ossible answers to the questions were presented to the researchers, who the n recorded their preferences anonymously. This was followed by open discuss ion when the results were known. In general, peers thought that early micro biological examinations are warranted and contribute to improving the use o f antibiotherapy. Nevertheless, no consensus was reached regarding choices of antimicrobial agents or the optimal duration of therapy. Piperacillin/ta zobactam was the preferred choice for empiric therapy, followed by a cephal osporin with antipseudomonal activity and a carbapenem. All the peers agree d that the pathogens causing VAP and multiresistance patterns in their ICUs were substantially different from those reported in studies in the United States. Pathogens and multiresistance patterns also varied from researcher to researcher inside the group. Consensus was reached on the importance of local epidemiology surveillance programs and on the need for customized emp iric antimicrobial choices to respond to local patterns of pathogens and su sceptibilities.