Ventilator-associated pneumonia: an update for clinicians.

VAP is a common problem faced by clinicians caring for critically ill patients. Use of appropriate preventive, diagnostic, and therapeutic strategies should minimize morbidity resulting from this clinical problem. Future investigations need to better define the optimum diagnostic methods and the most appropriate use of antibiotics for patients with suspected VAP. Only by developing these strategies can we hope to avoid the complications associated with spiraling empiricism. These complications include numerous outbreaks of serious antibiotic-resistant nosocomial infections due to the empiric over-administration of broad-spectrum antimicrobial agents. Advances in both the clinical and basic medical sciences are likely to help further elucidate the epidemiology and pathogenesis of VAP and, thereby, improve the opportunities for future prevention of this disorder.