Similarity – Rec – Guideline

similarity Recommendation Text Guideline Title
0.544947 For patients with HAP who are being treated empirically and have no risk factors for MRSA infection and are not at high risk of mortality, we suggest prescribing an antibiotic with activity against MSSA. When empiric treatment that includes coverage for MSSA (and not MRSA) is indicated, we suggest a regimen including piperacillin-tazobactam, cefepime, levofloxacin, imipenem, or meropenem. Oxacillin, nafcillin, or cefazolin are preferred for the treatment of proven MSSA, but are not necessary for empiric coverage of HAP if one of the above agents is used Hospital-Acquired and Ventilator-Associated Pneumonia
0.534291 For patients with HAP/VAP due to P. aeruginosa who are not in septic shock or at a high risk for death, and for whom the results of antibiotic susceptibility testing are known, we recommend monotherapy using an antibiotic to which the isolate is susceptible rather than combination therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.51257 For patients with HAP who are being treated empirically and have either a risk factor for MRSA infection (ie, prior intravenous antibiotic use within 90 days, hospitalization in a unit where >20% of S. aureus isolates are methicillin resistant, or the prevalence of MRSA is not known, or who are at high risk for mortality, we suggest prescribing an antibiotic with activity against MRSA Hospital-Acquired and Ventilator-Associated Pneumonia
0.499646 We suggest including an agent active against MRSA for the empiric treatment of suspected VAP only in patients with any of the following: a risk factor for antimicrobial resistance (Table 2), patients being treated in units where >10%–20% of S. aureus isolates are methicillin resistant, and patients in units where the prevalence of MRSA is not known Hospital-Acquired and Ventilator-Associated Pneumonia
0.48931 We suggest prescribing 2 antipseudomonal antibiotics from different classes for the empiric treatment of suspected VAP only in patients with any of the following: a risk factor for antimicrobial resistance (Table 2), patients in units where >10% of gram-negative isolates are resistant to an agent being considered for monotherapy, and patients in an ICU where local antimicrobial susceptibility rates are not available Hospital-Acquired and Ventilator-Associated Pneumonia
0.544947 For patients with HAP who are being treated empirically and have no risk factors for MRSA infection and are not at high risk of mortality, we suggest prescribing an antibiotic with activity against MSSA. When empiric treatment that includes coverage for MSSA (and not MRSA) is indicated, we suggest a regimen including piperacillin-tazobactam, cefepime, levofloxacin, imipenem, or meropenem. Oxacillin, nafcillin, or cefazolin are preferred for the treatment of proven MSSA, but are not necessary for empiric coverage of HAP if one of the above agents is used Hospital-Acquired and Ventilator-Associated Pneumonia
0.534291 For patients with HAP/VAP due to P. aeruginosa who are not in septic shock or at a high risk for death, and for whom the results of antibiotic susceptibility testing are known, we recommend monotherapy using an antibiotic to which the isolate is susceptible rather than combination therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.51257 For patients with HAP who are being treated empirically and have either a risk factor for MRSA infection (ie, prior intravenous antibiotic use within 90 days, hospitalization in a unit where >20% of S. aureus isolates are methicillin resistant, or the prevalence of MRSA is not known, or who are at high risk for mortality, we suggest prescribing an antibiotic with activity against MRSA Hospital-Acquired and Ventilator-Associated Pneumonia
0.499646 We suggest including an agent active against MRSA for the empiric treatment of suspected VAP only in patients with any of the following: a risk factor for antimicrobial resistance (Table 2), patients being treated in units where >10%–20% of S. aureus isolates are methicillin resistant, and patients in units where the prevalence of MRSA is not known Hospital-Acquired and Ventilator-Associated Pneumonia
0.48931 We suggest prescribing 2 antipseudomonal antibiotics from different classes for the empiric treatment of suspected VAP only in patients with any of the following: a risk factor for antimicrobial resistance (Table 2), patients in units where >10% of gram-negative isolates are resistant to an agent being considered for monotherapy, and patients in an ICU where local antimicrobial susceptibility rates are not available Hospital-Acquired and Ventilator-Associated Pneumonia
0.488708 For patients with HAP/VAP due to P. aeruginosa who remain in septic shock or at a high risk for death when the results of antibiotic susceptibility testing are known, we suggest combination therapy using 2 antibiotics to which the isolate is susceptible rather than monotherapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.481955 For patients with HAP/VAP due to ESBL-producing gramnegative bacilli, we recommend that the choice of an antibiotic for definitive (not empiric) therapy be based upon the results of antimicrobial susceptibility testing and patient-specific factors Hospital-Acquired and Ventilator-Associated Pneumonia
0.470399 For patients with HAP/VAP due to P. aeruginosa, we recommend that the choice of an antibiotic for definitive (not empiric) therapy be based upon the results of antimicrobial susceptibility testing Hospital-Acquired and Ventilator-Associated Pneumonia
0.463304 For patients with HAP who are being treated empirically and have factors increasing the likelihood for Pseudomonas or other gram-negative infection (ie, prior intravenous antibiotic use within 90 days; also see Remarks) or a high risk for mortality, we suggest prescribing antibiotics from 2 different classes with activity against P. aeruginosa Hospital-Acquired and Ventilator-Associated Pneumonia
0.455066 When empiric treatment that includes coverage for MSSA (and not MRSA) is indicated, we suggest a regimen including piperacillin-tazobactam, cefepime, levofloxacin, imipenem, or meropenem. Oxacillin, nafcillin, or cefazolin are preferred for the treatment of proven MSSA, but are not necessary for empiric coverage of HAP if one of the above agents is used Hospital-Acquired and Ventilator-Associated Pneumonia
0.449838 We suggest prescribing one antibiotic active against P. aeruginosa for the empiric treatment of suspected VAP in patients without risk factors for antimicrobial resistance who are being treated in ICUs where ?10% of gram-negative isolates are resistant to the agent being considered for monotherapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.446247 For patients with suspected HAP/VAP, we suggest not using the CPIS to guide the discontinuation of antibiotic therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.435373 When empiric treatment that includes coverage for MSSA (and not MRSA) is indicated, we suggest a regimen including piperacillin-tazobactam, cefepime, levofloxacin, imipenem, or meropenem (weak recommendation, very low-quality evidence). Oxacillin, nafcillin, or cefazolin are preferred agents for treatment of proven MSSA, but are not necessary for the empiric treatment of VAP if one of the above agents is used. Hospital-Acquired and Ventilator-Associated Pneumonia
0.417181 We suggest including an agent active against methicillinsensitive S. aureus (MSSA) (and not MRSA) for the empiric treatment of suspected VAP in patients without risk factors for antimicrobial resistance, who are being treated in ICUs where <10%–20% of S. aureus isolates are methicillin resistant (weak recommendation, very low-quality evidence). Hospital-Acquired and Ventilator-Associated Pneumonia
0.391689 Oxacillin, nafcillin, or cefazolin are preferred agents for treatment of proven MSSA, but are not necessary for the empiric treatment of VAP if one of the above agents is used Hospital-Acquired and Ventilator-Associated Pneumonia
0.39006 For patients with VAP due to gram-negative bacilli that are susceptible to only aminoglycosides or polymyxins (colistin or polymyxin B), we suggest both inhaled and systemic antibiotics, rather than systemic antibiotics alone Hospital-Acquired and Ventilator-Associated Pneumonia
0.38024 In patients with HAP/VAP caused by Acinetobacter species, we suggest treatment with either a carbapenem or ampicillin/sulbactam if the isolate is susceptible to these agents Hospital-Acquired and Ventilator-Associated Pneumonia
0.372235 For patients with HAP/VAP, we suggest using PCT levels plus clinical criteria to guide the discontinuation of antibiotic therapy, rather than clinical criteria alone Hospital-Acquired and Ventilator-Associated Pneumonia
0.369354 For patients with HAP who require empiric coverage for MRSA, we recommend vancomycin or linezolid rather than an alternative antibiotic Hospital-Acquired and Ventilator-Associated Pneumonia
0.360495 For patients with HAP who are being treated empirically, we recommend prescribing antibiotics with activity against P. aeruginosa and other gram-negative bacilli Hospital-Acquired and Ventilator-Associated Pneumonia
0.355196 For patients with suspected HAP/VAP, we suggest using clinical criteria alone, rather than using CPIS plus clinical criteria, to decide whether or not to initiate antibiotic therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.35347 Noninvasive sampling with semiquantitative cultures is the preferred methodology to diagnose VAP (see section I); however, the panel recognizes that invasive quantitative cultures will occasionally be performed by some clinicians. For patients with suspected VAP whose invasive quantitative culture results are below the diagnostic threshold for VAP, we suggest that antibiotics be withheld rather than continued Hospital-Acquired and Ventilator-Associated Pneumonia
0.3534 For patients with suspected HAP/VAP, we recommend using clinical criteria alone rather than using CRP plus clinical criteria, to decide whether or not to initiate antibiotic therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.350465 For patients with HAP, we recommend a 7-day course of antimicrobial therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.349478 For patients with suspected HAP/VAP, we recommend using clinical criteria alone, rather than using serum PCT plus clinical criteria, to decide whether or not to initiate antibiotic therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.349179 In patients with suspected VAP, we recommend including coverage for S. aureus, Pseudomonas aeruginosa, and other gram-negative bacilli in all empiric regimens Hospital-Acquired and Ventilator-Associated Pneumonia
0.344868 In patients with HAP/VAP caused by Acinetobacter species, we recommend against the use of tigecycline Hospital-Acquired and Ventilator-Associated Pneumonia
0.340408 For patients with suspected HAP/VAP, we recommend using clinical criteria alone, rather than using bronchoalveolar lavage fluid (BALF) sTREM-1 plus clinical criteria, to decide whether or not to initiate antibiotic therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.339961 For patients being treated empirically for HAP, we recommend prescribing an antibiotic with activity against S. aureus Hospital-Acquired and Ventilator-Associated Pneumonia
0.337035 In patients with HAP/VAP caused by a carbapenem-resistant pathogen that is sensitive only to polymyxins, we recommend intravenous polymyxins (colistin or polymyxin B) Hospital-Acquired and Ventilator-Associated Pneumonia
0.333707 For patients with HAP/VAP, we suggest that antibiotic dosing be determined using PK/PD data, rather than the manufacturer’s prescribing information Hospital-Acquired and Ventilator-Associated Pneumonia
0.332558 For patients with VAP, we recommend a 7-day course of antimicrobial therapy rather than a longer duration Hospital-Acquired and Ventilator-Associated Pneumonia
0.328341 For patients with HAP who are being treated empirically, we recommend not using an aminoglycoside as the sole antipseudomonal agent Hospital-Acquired and Ventilator-Associated Pneumonia
0.327635 For patients with HAP/VAP due to P. aeruginosa, we recommend against aminoglycoside monotherapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.325335 For patients with HAP/VAP, we suggest that antibiotic therapy be de-escalated rather than fixed Hospital-Acquired and Ventilator-Associated Pneumonia
0.323853 In patients with HAP/VAP caused by Acinetobacter species that is sensitive only to polymyxins, we recommend intravenous polymyxin (colistin or polymyxin B) Hospital-Acquired and Ventilator-Associated Pneumonia
0.317082 We recommend that MRSA HAP/VAP be treated with either vancomycin or linezolid rather than other antibiotics or antibiotic combinations Hospital-Acquired and Ventilator-Associated Pneumonia
0.31212 We suggest that patients with suspected HAP (non-VAP) be treated according to the results of microbiologic studies performed on respiratory samples obtained noninvasively, rather than being treated empirically Hospital-Acquired and Ventilator-Associated Pneumonia
0.302721 In patients with HAP/VAP caused by a carbapenem-resistant pathogen that is sensitive only to polymyxins, we suggest adjunctive inhaled colistin Hospital-Acquired and Ventilator-Associated Pneumonia
0.300438 In patients with HAP/VAP caused by Acinetobacter species that is sensitive only to colistin, we suggest not using adjunctive rifampicin Hospital-Acquired and Ventilator-Associated Pneumonia
0.287976 In patients with HAP/VAP caused by Acinetobacter species that is sensitive only to polymyxins, we suggest adjunctive inhaled colistin Hospital-Acquired and Ventilator-Associated Pneumonia
0.280746 For patients with HAP/VAP due to P. aeruginosa, we recommend against aminoglycoside monotherapy (strong recommendation, very low-quality evidence). Hospital-Acquired and Ventilator-Associated Pneumonia
0.274568 In patients with suspected VAP, we suggest avoiding colistin if alternative agents with adequate gram-negative activity are available Hospital-Acquired and Ventilator-Associated Pneumonia
0.269865 In patients with suspected VAP, we suggest avoiding aminoglycosides if alternative agents with adequate gram-negative activity are available Hospital-Acquired and Ventilator-Associated Pneumonia
0.241365 If empiric coverage for MRSA is indicated, we recommend either vancomycin or linezolid Hospital-Acquired and Ventilator-Associated Pneumonia
0.239414 In patients with VAT, we suggest not providing antibiotic therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.224479 We suggest noninvasive sampling with semiquantitative cultures to diagnose VAP, rather than invasive sampling with quantitative cultures and rather than noninvasive sampling with quantitative cultures Hospital-Acquired and Ventilator-Associated Pneumonia
0.331308 For patients with HAP who are being treated empirically and have no risk factors for MRSA infection and are not at high risk of mortality, we suggest prescribing an antibiotic with activity against MSSA. When empiric treatment that includes coverage for MSSA (and not MRSA) is indicated, we suggest a regimen including piperacillin-tazobactam, cefepime, levofloxacin, imipenem, or meropenem. Oxacillin, nafcillin, or cefazolin are preferred for the treatment of proven MSSA, but are not necessary for empiric coverage of HAP if one of the above agents is used Hospital-Acquired and Ventilator-Associated Pneumonia
0.280739 We suggest including an agent active against MRSA for the empiric treatment of suspected VAP only in patients with any of the following: a risk factor for antimicrobial resistance (Table 2), patients being treated in units where >10%–20% of S. aureus isolates are methicillin resistant, and patients in units where the prevalence of MRSA is not known Hospital-Acquired and Ventilator-Associated Pneumonia
0.273886 For patients with HAP who are being treated empirically and have either a risk factor for MRSA infection (ie, prior intravenous antibiotic use within 90 days, hospitalization in a unit where >20% of S. aureus isolates are methicillin resistant, or the prevalence of MRSA is not known, or who are at high risk for mortality, we suggest prescribing an antibiotic with activity against MRSA Hospital-Acquired and Ventilator-Associated Pneumonia
0.2737 We suggest prescribing 2 antipseudomonal antibiotics from different classes for the empiric treatment of suspected VAP only in patients with any of the following: a risk factor for antimicrobial resistance (Table 2), patients in units where >10% of gram-negative isolates are resistant to an agent being considered for monotherapy, and patients in an ICU where local antimicrobial susceptibility rates are not available Hospital-Acquired and Ventilator-Associated Pneumonia
0.270612 For patients with HAP/VAP due to P. aeruginosa who are not in septic shock or at a high risk for death, and for whom the results of antibiotic susceptibility testing are known, we recommend monotherapy using an antibiotic to which the isolate is susceptible rather than combination therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.269637 When empiric treatment that includes coverage for MSSA (and not MRSA) is indicated, we suggest a regimen including piperacillin-tazobactam, cefepime, levofloxacin, imipenem, or meropenem. Oxacillin, nafcillin, or cefazolin are preferred for the treatment of proven MSSA, but are not necessary for empiric coverage of HAP if one of the above agents is used Hospital-Acquired and Ventilator-Associated Pneumonia
0.267636 When empiric treatment that includes coverage for MSSA (and not MRSA) is indicated, we suggest a regimen including piperacillin-tazobactam, cefepime, levofloxacin, imipenem, or meropenem (weak recommendation, very low-quality evidence). Oxacillin, nafcillin, or cefazolin are preferred agents for treatment of proven MSSA, but are not necessary for the empiric treatment of VAP if one of the above agents is used. Hospital-Acquired and Ventilator-Associated Pneumonia
0.263246 For patients with VAP due to gram-negative bacilli that are susceptible to only aminoglycosides or polymyxins (colistin or polymyxin B), we suggest both inhaled and systemic antibiotics, rather than systemic antibiotics alone Hospital-Acquired and Ventilator-Associated Pneumonia
0.240285 Oxacillin, nafcillin, or cefazolin are preferred agents for treatment of proven MSSA, but are not necessary for the empiric treatment of VAP if one of the above agents is used Hospital-Acquired and Ventilator-Associated Pneumonia
0.229912 For patients with HAP/VAP due to P. aeruginosa who remain in septic shock or at a high risk for death when the results of antibiotic susceptibility testing are known, we suggest combination therapy using 2 antibiotics to which the isolate is susceptible rather than monotherapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.219609 We suggest prescribing one antibiotic active against P. aeruginosa for the empiric treatment of suspected VAP in patients without risk factors for antimicrobial resistance who are being treated in ICUs where ?10% of gram-negative isolates are resistant to the agent being considered for monotherapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.215472 For patients with HAP/VAP due to ESBL-producing gramnegative bacilli, we recommend that the choice of an antibiotic for definitive (not empiric) therapy be based upon the results of antimicrobial susceptibility testing and patient-specific factors Hospital-Acquired and Ventilator-Associated Pneumonia
0.214534 For patients with HAP who are being treated empirically and have factors increasing the likelihood for Pseudomonas or other gram-negative infection (ie, prior intravenous antibiotic use within 90 days; also see Remarks) or a high risk for mortality, we suggest prescribing antibiotics from 2 different classes with activity against P. aeruginosa Hospital-Acquired and Ventilator-Associated Pneumonia
0.211481 For patients with suspected HAP/VAP, we suggest not using the CPIS to guide the discontinuation of antibiotic therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.20685 We suggest including an agent active against methicillinsensitive S. aureus (MSSA) (and not MRSA) for the empiric treatment of suspected VAP in patients without risk factors for antimicrobial resistance, who are being treated in ICUs where <10%–20% of S. aureus isolates are methicillin resistant (weak recommendation, very low-quality evidence). Hospital-Acquired and Ventilator-Associated Pneumonia
0.20522 For patients with HAP/VAP due to P. aeruginosa, we recommend that the choice of an antibiotic for definitive (not empiric) therapy be based upon the results of antimicrobial susceptibility testing Hospital-Acquired and Ventilator-Associated Pneumonia
0.189083 For patients with HAP/VAP due to P. aeruginosa, we recommend against aminoglycoside monotherapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.189 In patients with HAP/VAP caused by Acinetobacter species, we recommend against the use of tigecycline Hospital-Acquired and Ventilator-Associated Pneumonia
0.187188 In patients with HAP/VAP caused by a carbapenem-resistant pathogen that is sensitive only to polymyxins, we recommend intravenous polymyxins (colistin or polymyxin B) Hospital-Acquired and Ventilator-Associated Pneumonia
0.181877 For patients with suspected HAP/VAP, we suggest using clinical criteria alone, rather than using CPIS plus clinical criteria, to decide whether or not to initiate antibiotic therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.181432 In patients with HAP/VAP caused by Acinetobacter species that is sensitive only to colistin, we suggest not using adjunctive rifampicin Hospital-Acquired and Ventilator-Associated Pneumonia
0.181001 For patients with suspected HAP/VAP, we recommend using clinical criteria alone rather than using CRP plus clinical criteria, to decide whether or not to initiate antibiotic therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.180837 For patients with suspected HAP/VAP, we recommend using clinical criteria alone, rather than using serum PCT plus clinical criteria, to decide whether or not to initiate antibiotic therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.178029 For patients with HAP who are being treated empirically, we recommend not using an aminoglycoside as the sole antipseudomonal agent Hospital-Acquired and Ventilator-Associated Pneumonia
0.177154 For patients with HAP/VAP due to P. aeruginosa, we recommend against aminoglycoside monotherapy (strong recommendation, very low-quality evidence). Hospital-Acquired and Ventilator-Associated Pneumonia
0.17596 In patients with HAP/VAP caused by Acinetobacter species that is sensitive only to polymyxins, we recommend intravenous polymyxin (colistin or polymyxin B) Hospital-Acquired and Ventilator-Associated Pneumonia
0.175462 In patients with HAP/VAP caused by a carbapenem-resistant pathogen that is sensitive only to polymyxins, we suggest adjunctive inhaled colistin Hospital-Acquired and Ventilator-Associated Pneumonia
0.173275 In patients with HAP/VAP caused by Acinetobacter species, we suggest treatment with either a carbapenem or ampicillin/sulbactam if the isolate is susceptible to these agents Hospital-Acquired and Ventilator-Associated Pneumonia
0.169631 For patients with suspected HAP/VAP, we recommend using clinical criteria alone, rather than using bronchoalveolar lavage fluid (BALF) sTREM-1 plus clinical criteria, to decide whether or not to initiate antibiotic therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.168945 For patients with HAP who require empiric coverage for MRSA, we recommend vancomycin or linezolid rather than an alternative antibiotic Hospital-Acquired and Ventilator-Associated Pneumonia
0.168661 In patients with suspected VAP, we recommend including coverage for S. aureus, Pseudomonas aeruginosa, and other gram-negative bacilli in all empiric regimens Hospital-Acquired and Ventilator-Associated Pneumonia
0.166645 For patients with HAP who are being treated empirically, we recommend prescribing antibiotics with activity against P. aeruginosa and other gram-negative bacilli Hospital-Acquired and Ventilator-Associated Pneumonia
0.165705 For patients with HAP/VAP, we suggest using PCT levels plus clinical criteria to guide the discontinuation of antibiotic therapy, rather than clinical criteria alone Hospital-Acquired and Ventilator-Associated Pneumonia
0.165526 Noninvasive sampling with semiquantitative cultures is the preferred methodology to diagnose VAP (see section I); however, the panel recognizes that invasive quantitative cultures will occasionally be performed by some clinicians. For patients with suspected VAP whose invasive quantitative culture results are below the diagnostic threshold for VAP, we suggest that antibiotics be withheld rather than continued Hospital-Acquired and Ventilator-Associated Pneumonia
0.165005 For patients with HAP/VAP, we suggest that antibiotic dosing be determined using PK/PD data, rather than the manufacturer’s prescribing information Hospital-Acquired and Ventilator-Associated Pneumonia
0.163964 We recommend that MRSA HAP/VAP be treated with either vancomycin or linezolid rather than other antibiotics or antibiotic combinations Hospital-Acquired and Ventilator-Associated Pneumonia
0.162728 In patients with HAP/VAP caused by Acinetobacter species that is sensitive only to polymyxins, we suggest adjunctive inhaled colistin Hospital-Acquired and Ventilator-Associated Pneumonia
0.143428 For patients with HAP/VAP, we suggest that antibiotic therapy be de-escalated rather than fixed Hospital-Acquired and Ventilator-Associated Pneumonia
0.134304 For patients being treated empirically for HAP, we recommend prescribing an antibiotic with activity against S. aureus Hospital-Acquired and Ventilator-Associated Pneumonia
0.132399 For patients with VAP, we recommend a 7-day course of antimicrobial therapy rather than a longer duration Hospital-Acquired and Ventilator-Associated Pneumonia
0.131184 We suggest that patients with suspected HAP (non-VAP) be treated according to the results of microbiologic studies performed on respiratory samples obtained noninvasively, rather than being treated empirically Hospital-Acquired and Ventilator-Associated Pneumonia
0.127432 For patients with HAP, we recommend a 7-day course of antimicrobial therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.124135 We suggest noninvasive sampling with semiquantitative cultures to diagnose VAP, rather than invasive sampling with quantitative cultures and rather than noninvasive sampling with quantitative cultures Hospital-Acquired and Ventilator-Associated Pneumonia
0.119067 In patients with suspected VAP, we suggest avoiding colistin if alternative agents with adequate gram-negative activity are available Hospital-Acquired and Ventilator-Associated Pneumonia
0.117154 In patients with suspected VAP, we suggest avoiding aminoglycosides if alternative agents with adequate gram-negative activity are available Hospital-Acquired and Ventilator-Associated Pneumonia
0.11364 If empiric coverage for MRSA is indicated, we recommend either vancomycin or linezolid Hospital-Acquired and Ventilator-Associated Pneumonia
0.0871315 In patients with VAT, we suggest not providing antibiotic therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.154138 We suggest prescribing 2 antipseudomonal antibiotics from different classes for the empiric treatment of suspected VAP only in patients with any of the following: a risk factor for antimicrobial resistance (Table 2), patients in units where >10% of gram-negative isolates are resistant to an agent being considered for monotherapy, and patients in an ICU where local antimicrobial susceptibility rates are not available Hospital-Acquired and Ventilator-Associated Pneumonia
0.152755 We suggest prescribing one antibiotic active against P. aeruginosa for the empiric treatment of suspected VAP in patients without risk factors for antimicrobial resistance who are being treated in ICUs where ?10% of gram-negative isolates are resistant to the agent being considered for monotherapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.140128 For patients with HAP who are being treated empirically and have either a risk factor for MRSA infection (ie, prior intravenous antibiotic use within 90 days, hospitalization in a unit where >20% of S. aureus isolates are methicillin resistant, or the prevalence of MRSA is not known, or who are at high risk for mortality, we suggest prescribing an antibiotic with activity against MRSA Hospital-Acquired and Ventilator-Associated Pneumonia
0.137571 For patients with HAP/VAP due to ESBL-producing gramnegative bacilli, we recommend that the choice of an antibiotic for definitive (not empiric) therapy be based upon the results of antimicrobial susceptibility testing and patient-specific factors Hospital-Acquired and Ventilator-Associated Pneumonia
0.130309 Noninvasive sampling with semiquantitative cultures is the preferred methodology to diagnose VAP (see section I); however, the panel recognizes that invasive quantitative cultures will occasionally be performed by some clinicians. For patients with suspected VAP whose invasive quantitative culture results are below the diagnostic threshold for VAP, we suggest that antibiotics be withheld rather than continued Hospital-Acquired and Ventilator-Associated Pneumonia
0.129778 We suggest including an agent active against methicillinsensitive S. aureus (MSSA) (and not MRSA) for the empiric treatment of suspected VAP in patients without risk factors for antimicrobial resistance, who are being treated in ICUs where <10%–20% of S. aureus isolates are methicillin resistant (weak recommendation, very low-quality evidence). Hospital-Acquired and Ventilator-Associated Pneumonia
0.128083 For patients with HAP/VAP due to P. aeruginosa who remain in septic shock or at a high risk for death when the results of antibiotic susceptibility testing are known, we suggest combination therapy using 2 antibiotics to which the isolate is susceptible rather than monotherapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.127863 For patients with HAP who are being treated empirically and have factors increasing the likelihood for Pseudomonas or other gram-negative infection (ie, prior intravenous antibiotic use within 90 days; also see Remarks) or a high risk for mortality, we suggest prescribing antibiotics from 2 different classes with activity against P. aeruginosa Hospital-Acquired and Ventilator-Associated Pneumonia
0.127179 We suggest including an agent active against MRSA for the empiric treatment of suspected VAP only in patients with any of the following: a risk factor for antimicrobial resistance (Table 2), patients being treated in units where >10%–20% of S. aureus isolates are methicillin resistant, and patients in units where the prevalence of MRSA is not known Hospital-Acquired and Ventilator-Associated Pneumonia
0.124312 For patients with HAP who are being treated empirically and have no risk factors for MRSA infection and are not at high risk of mortality, we suggest prescribing an antibiotic with activity against MSSA. When empiric treatment that includes coverage for MSSA (and not MRSA) is indicated, we suggest a regimen including piperacillin-tazobactam, cefepime, levofloxacin, imipenem, or meropenem. Oxacillin, nafcillin, or cefazolin are preferred for the treatment of proven MSSA, but are not necessary for empiric coverage of HAP if one of the above agents is used Hospital-Acquired and Ventilator-Associated Pneumonia
0.123801 For patients with HAP/VAP due to P. aeruginosa, we recommend that the choice of an antibiotic for definitive (not empiric) therapy be based upon the results of antimicrobial susceptibility testing Hospital-Acquired and Ventilator-Associated Pneumonia
0.1236 We recommend that MRSA HAP/VAP be treated with either vancomycin or linezolid rather than other antibiotics or antibiotic combinations Hospital-Acquired and Ventilator-Associated Pneumonia
0.118882 For patients with HAP/VAP due to P. aeruginosa who are not in septic shock or at a high risk for death, and for whom the results of antibiotic susceptibility testing are known, we recommend monotherapy using an antibiotic to which the isolate is susceptible rather than combination therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.111971 We suggest that patients with suspected HAP (non-VAP) be treated according to the results of microbiologic studies performed on respiratory samples obtained noninvasively, rather than being treated empirically Hospital-Acquired and Ventilator-Associated Pneumonia
0.111521 For patients with HAP/VAP, we suggest that antibiotic dosing be determined using PK/PD data, rather than the manufacturer’s prescribing information Hospital-Acquired and Ventilator-Associated Pneumonia
0.111096 For patients with suspected HAP/VAP, we recommend using clinical criteria alone rather than using CRP plus clinical criteria, to decide whether or not to initiate antibiotic therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.111096 For patients with suspected HAP/VAP, we recommend using clinical criteria alone, rather than using serum PCT plus clinical criteria, to decide whether or not to initiate antibiotic therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.111096 For patients with suspected HAP/VAP, we suggest using clinical criteria alone, rather than using CPIS plus clinical criteria, to decide whether or not to initiate antibiotic therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.11106 For patients being treated empirically for HAP, we recommend prescribing an antibiotic with activity against S. aureus Hospital-Acquired and Ventilator-Associated Pneumonia
0.109797 For patients with HAP who require empiric coverage for MRSA, we recommend vancomycin or linezolid rather than an alternative antibiotic Hospital-Acquired and Ventilator-Associated Pneumonia
0.109254 For patients with VAP, we recommend a 7-day course of antimicrobial therapy rather than a longer duration Hospital-Acquired and Ventilator-Associated Pneumonia
0.100611 For patients with suspected HAP/VAP, we recommend using clinical criteria alone, rather than using bronchoalveolar lavage fluid (BALF) sTREM-1 plus clinical criteria, to decide whether or not to initiate antibiotic therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.100268 For patients with VAP due to gram-negative bacilli that are susceptible to only aminoglycosides or polymyxins (colistin or polymyxin B), we suggest both inhaled and systemic antibiotics, rather than systemic antibiotics alone Hospital-Acquired and Ventilator-Associated Pneumonia
0.0992365 For patients with suspected HAP/VAP, we suggest not using the CPIS to guide the discontinuation of antibiotic therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.0987273 In patients with HAP/VAP caused by Acinetobacter species, we suggest treatment with either a carbapenem or ampicillin/sulbactam if the isolate is susceptible to these agents Hospital-Acquired and Ventilator-Associated Pneumonia
0.0983226 For patients with HAP/VAP, we suggest using PCT levels plus clinical criteria to guide the discontinuation of antibiotic therapy, rather than clinical criteria alone Hospital-Acquired and Ventilator-Associated Pneumonia
0.0965804 In patients with HAP/VAP caused by Acinetobacter species that is sensitive only to polymyxins, we suggest adjunctive inhaled colistin Hospital-Acquired and Ventilator-Associated Pneumonia
0.0920141 In patients with suspected VAP, we suggest avoiding aminoglycosides if alternative agents with adequate gram-negative activity are available Hospital-Acquired and Ventilator-Associated Pneumonia
0.0920141 In patients with suspected VAP, we suggest avoiding colistin if alternative agents with adequate gram-negative activity are available Hospital-Acquired and Ventilator-Associated Pneumonia
0.0918134 In patients with VAT, we suggest not providing antibiotic therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.0895569 For patients with HAP, we recommend a 7-day course of antimicrobial therapy Hospital-Acquired and Ventilator-Associated Pneumonia
0.0878004 In patients with HAP/VAP caused by a carbapenem-resistant pathogen that is sensitive only to polymyxins, we suggest adjunctive inhaled colistin Hospital-Acquired and Ventilator-Associated Pneumonia
0.0877341 If empiric coverage for MRSA is indicated, we recommend either vancomycin or linezolid Hospital-Acquired and Ventilator-Associated Pneumonia
0.084856 For patients with HAP/VAP, we suggest that antibiotic therapy be de-escalated rather than fixed Hospital-Acquired and Ventilator-Associated Pneumonia
0.0847392 For patients with HAP who are being treated empirically, we recommend prescribing antibiotics with activity against P. aeruginosa and other gram-negative bacilli Hospital-Acquired and Ventilator-Associated Pneumonia
0.0817534 In patients with HAP/VAP caused by Acinetobacter species that is sensitive only to colistin, we suggest not using adjunctive rifampicin Hospital-Acquired and Ventilator-Associated Pneumonia
0.0792227 In patients with HAP/VAP caused by Acinetobacter species that is sensitive only to polymyxins, we recommend intravenous polymyxin (colistin or polymyxin B) Hospital-Acquired and Ventilator-Associated Pneumonia
0.0781374 When empiric treatment that includes coverage for MSSA (and not MRSA) is indicated, we suggest a regimen including piperacillin-tazobactam, cefepime, levofloxacin, imipenem, or meropenem (weak recommendation, very low-quality evidence). Oxacillin, nafcillin, or cefazolin are preferred agents for treatment of proven MSSA, but are not necessary for the empiric treatment of VAP if one of the above agents is used. Hospital-Acquired and Ventilator-Associated Pneumonia
0.0770636 We suggest noninvasive sampling with semiquantitative cultures to diagnose VAP, rather than invasive sampling with quantitative cultures and rather than noninvasive sampling with quantitative cultures Hospital-Acquired and Ventilator-Associated Pneumonia
0.0741515 In patients with suspected VAP, we recommend including coverage for S. aureus, Pseudomonas aeruginosa, and other gram-negative bacilli in all empiric regimens Hospital-Acquired and Ventilator-Associated Pneumonia
0.0738508 When empiric treatment that includes coverage for MSSA (and not MRSA) is indicated, we suggest a regimen including piperacillin-tazobactam, cefepime, levofloxacin, imipenem, or meropenem. Oxacillin, nafcillin, or cefazolin are preferred for the treatment of proven MSSA, but are not necessary for empiric coverage of HAP if one of the above agents is used Hospital-Acquired and Ventilator-Associated Pneumonia
0.0721354 In patients with HAP/VAP caused by Acinetobacter species, we recommend against the use of tigecycline Hospital-Acquired and Ventilator-Associated Pneumonia
0.0716777 In patients with HAP/VAP caused by a carbapenem-resistant pathogen that is sensitive only to polymyxins, we recommend intravenous polymyxins (colistin or polymyxin B) Hospital-Acquired and Ventilator-Associated Pneumonia
0.0646094 Oxacillin, nafcillin, or cefazolin are preferred agents for treatment of proven MSSA, but are not necessary for the empiric treatment of VAP if one of the above agents is used Hospital-Acquired and Ventilator-Associated Pneumonia
0.0537665 For patients with HAP/VAP due to P. aeruginosa, we recommend against aminoglycoside monotherapy (strong recommendation, very low-quality evidence). Hospital-Acquired and Ventilator-Associated Pneumonia
0.0430132 For patients with HAP who are being treated empirically, we recommend not using an aminoglycoside as the sole antipseudomonal agent Hospital-Acquired and Ventilator-Associated Pneumonia
0.0395354 For patients with HAP/VAP due to P. aeruginosa, we recommend against aminoglycoside monotherapy Hospital-Acquired and Ventilator-Associated Pneumonia