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JAC Advance Access published online on April 29, 2008
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkn162
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Review

Guidelines for the management of hospital-acquired pneumonia in the UK: Report of the Working Party on Hospital-Acquired Pneumonia of the British Society for Antimicrobial Chemotherapy

R. G. Masterton1,*, A. Galloway2, G. French3, M. Street4, J. Armstrong5, E. Brown6, J. Cleverley7, P. Dilworth8, C. Fry9, A. D. Gascoigne10, Alan Knox11, Dilip Nathwani12, Robert Spencer13 and Mark Wilcox14

1 Department of Microbiology, Crosshouse Hospital, Kilmarnock, UK 2 Department of Microbiology, Royal Victoria Infirmary, Queen Victoria Road, Newcastle-upon-Tyne, UK 3 Department of Infection, Guy's and St Thomas's NHS Foundation Trust and King's College, St Thomas' Hospital, London, UK 4 Department of Intensive Care, Royal Sussex County Hospital, Brighton, UK 5 Department of Public Health, North Durham Strategic Health Authority, Earls House, Durham, UK 6 Department of Microbiology, Frenchay Hospital, Bristol, UK 7 Department of Radiology, Royal Free Hospital, London, UK 8 Department of Thoracic Medicine, Royal Free Hospital, London, UK 9 Department of Health, London, UK 10 Royal Victoria Infirmary, Queen Victoria Road, Newcastle-upon-Tyne, UK 11 Respiratory Medicine Unit, City Hospital, Nottingham, UK 12 Infection Unit, Ninewells Hospital and Medical School, Dundee, UK 13 Health Protection Agency, Bristol Royal Infirmary, Marlborough St, Bristol, UK 14 University of Leeds, Leeds, UK

* Corresponding author. Tel: +44-1292-614510; Fax: +44-1292-288952; E-mail: robert.masterton{at}aaaht.scot.nhs.uk

These evidence-based guidelines have been produced after a systematic literature review of a range of issues involving prevention, diagnosis and treatment of hospital-acquired pneumonia (HAP). Prevention is structured into sections addressing general issues, equipment, patient procedures and the environment, whereas in treatment, the structure addresses the use of antimicrobials in prevention and treatment, adjunctive therapies and the application of clinical protocols. The sections dealing with diagnosis are presented against the clinical, radiological and microbiological diagnosis of HAP. Recommendations are also made upon the role of invasive sampling and quantitative microbiology of respiratory secretions in directing antibiotic therapy in HAP/ventilator-associated pneumonia.

Key Words: hospital-acquired pneumonia , healthcare-associated pneumonia , evidence-based guidelines , prevention , diagnosis , antimicrobial treatment


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