Risk-factors for nosocomial pneumonia - Focus on prophylaxis

Despite an increased understanding of the pathogenesis of nosocomial pneumo nia and advances in diagnosis and treatment, the risk, cost, morbidity, and mortality of nosocomial pneumonia remain unacceptably high. The authors id entify specific risk factors for nosocomial pneumonia, including the host, infection control practices, use of pharmacologic agents, and invasive devi ces that are potential targets for prophylaxis. Data are presented from rec ently published guidelines for prevention of nosocomial pneumonia that are simple and cost effective but not commonly integrated into routine patient care. The authors recommend that strategies for prophylaxis of nosocomial a nd ventilator-associated pneumonia be implemented by a multidisciplinary te am comprised of physicians (critical care, pulmonary medicine, infectious d iseases, and primary care), critical care and infection control nurses, and respiratory therapists. The goal should be better overall patient care, ev en if it may result in decreased professional autonomy and freedom.