Abstract

PURPOSE: VAP is the most common acquired infection in mechanically ventilated patients. It occurs more than 48 hours after intubation with a 2-10 times higher mortality risk. There is no gold standard for diagnosis and therapy is usually empiric. A number of studies have demonstrated the appropriateness of the initial antibiotic regimen as a vital factor in determining outcome. Therefore, the correct choice of the empiric regimen is crucial. A VAP protocol was introduced at our institution in October 2001 which included cefepime and gentamicin as the empiric antibiotics of choice (alternative: cefepime and levofloxacin in patients with acute renal failure).

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