ABSTRACT
Bacterial resistance to antibiotics creates a therapeutic challenge to clinicians when treating patients with a known or suspected infection. Increasing rates of resistance lead many clinicians to empirically treat patients with multiple broad-spectrum antibiotics, which can perpetuate the cycle of increasing resistance and create an economic burden to society. De-escalation therapy is a treatment strategy that attempts to provide appropriate initial antimicrobial therapy to reduce the risk of negative patient outcomes and avoid the consequences of excessive or unnecessary antibiotic administration. To make the most accurate microbiologic diagnosis of an infection, infected body materials must be obtained before the administration of antimicrobial therapy. Antibiotic practice guidelines or protocols, particularly for the treatment of ventilator-associated pneumonia (VAP), have emerged as a potentially effective means of both avoiding unnecessary antibiotic administration and limiting the course of therapy without compromising patient outcomes. Antibiotic management of bronchoscopically-confirmed, uncomplicated VAP treated initially with appropriate therapy should be limited to a short duration.
