The British Society for Antimicrobial Chemotherapy (BSAC) has published evidencebased guidelines to address the management of hospital-acquired pneumonia (HAP), which is the most common hospital-acquired infection in intubated patients – increasing mortality by up to 75%. Following four years of data analysis, the guidance has been developed to tackle a range of issues including prevention, diagnosis and treatment, in order to reduce the inconsistencies in its management across the UK.
In current practice, healthcare professionals may wait for the results of diagnostic tests before choosing which antibiotic to treat with – yet this process promotes the emergence of antibiotic resistance which therefore increases the patient’s risk of mortality. The HAP guidelines recommend the need to treat “hard and fast” with an appropriate antibiotic. They advise that until the causative bacterium is known, an empirical broad spectrum antibiotic which is effective against the most common bacteria in that particular hospital or unit should be used. In all cases it is recommended that the local problem bacteria need to be taken into account when choosing an antibiotic.
Once the source of the HAP has been confirmed, the guidelines recommend switching to an antibiotic that targets the specific bacteria causing the infection. The use of a single antibiotic is recommended as there are no benefits in using combination therapy. Finally, treatment should not be continued for more than eight days as this has not demonstrated any benefits for patients and increases the risk of resistance. For a copy of the full guidelines, visit www.bsac.org.uk
