Moving Towards Real-Time Antimicrobial Management of Ventilator-Associated Pneumonia

Open Access
Publisher Website
Google Scholar
Abstract
In this issue of Clinical Infectious Diseases Bouza et al. [1] describe a rapid method for determining the antimicrobial susceptibility of bacterial pathogens associated with ventilator-associated pneumonia (VAP). They used E-test antibiotic strips (AB Biodisk) applied directly to respiratory tract samples. Using this rapid E-test method, antimicrobial susceptibility data was available within a mean of 1.4 days, compared with 4.2 days for definitive reports using standard methods. Patients who were managed using the rapid E-test method experienced statistically greater administration of appropriate antimicrobial therapy (an antibiotic regimen to which the pathogens were sensitive, determined on the basis of in vitro susceptibility testing), fewer overall days of receipt of antimicrobial treatment, more-rapid resolution of fever, and less Clostridium difficile-associated diarrhea [1]. Overall, the use of the E-test method to establish a rapid microbiologic diagnosis of VAP appeared to be beneficial. However, several limitations of this investigation must be appreciated to place it in a proper context.