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Thorax 57:366-371 doi:10.1136/thorax.57.4.366
  • Review series

The pulmonary physician in critical care • 4: Nosocomial pneumonia

  1. S Ewig,
  2. T Bauer,
  3. A Torres
  1. Institut Clinic de Pneumologia i Cirurgia Toracica, Hospital Clinic, Servei de Pneumologia i Al.lergia Respiratoria, Villarroel 170, 08036 Barcelona, Spain
  1. Correspondence to:
    Dr A Torres, Hospital Clinic, Servei de Pneumologia i Al.lergia Respiratoria, Institut Clinic De Pneumologia i Cirurgia Toracica, Institut d'investigacions biomediques, August Pi i Sunyer (IDIBAPS), Villarroel 170, 08036 Barcelona, Spain;
    atorres{at}clinic.ub.es

    Abstract

    Much progress has been made in the understanding of nosocomial pneumonia but important issues in diagnosis and treatment remain unresolved. The controversy over diagnostic tools should be closed. Instead, every effort should be made to increase our ability to make valid clinical predictions about the presence of ventilator associated pneumonia and to establish criteria to guide restricting empirical antimicrobial treatment without causing patient harm. More emphasis must be put on local infection control measures such as routine surveillance of pathogens, definition of controlled policies of antimicrobial treatment, and effective implementation of strategies of prevention.