Review article
Prevention of hospital-acquired pneumonia:: European perspective

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Guidelines and systematic reviews

Guidelines for the prevention of hospital-acquired or nosocomial pneumonia have been formulated by the American Thoracic Society [1] and by the Centers for Disease Control and Prevention with the consensus recommendations of the Hospital Infection Control Practices Advisory Committee [2]. Both guidelines were revised in 2003. In a recent review prospective and controlled studies on the prevention of VAP, performed between 1966 and 2001, were systematically analyzed [3]. After reviewing 433

Summary

Several preventive measures for VAP have been empirically tested. There is clear evidence that antibiotic-containing preventive strategies, such as SDD and oropharyngeal decontamination, are very effective in different patient populations. Selection of antibiotic resistance remains the major disadvantage of these strategies, however, limiting its applicability in settings with high levels of antibiotic resistance. This probably precludes the use of these strategies in many American settings,

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