ABSTRACT
A patient’s risk of pneumonia is increased 6 to 21-fold with intubation and mechanical ventilation (1-3). Ventilator-associated pneumonia (VAP) is defined as new pneumonia, which develops more than 48-72 hr after intubation (1). Early-onset VAP, which occurs within the first 5 days of intubation, carries a better prognosis and is more likely to be caused by aspiration of antibiotic-sensitive bacteria colonizing the oropharynx than late-onset VAP (4-6). The latter, which occurs more than 5 days after intubation, is often caused by nosocomial pathogens that are often multidrug-resistant (MDR), and has a higher mortality and morbidity than early-onset disease. Exceptions to this include patients who have received antibiotics earlier, and those with prior hospitalization, or residence in a chronic care or nursing home facility who may have pathogens similar to those with late-onset VAP (6).
