Hospital-acquired pneumonia

Key points

• Hospital-acquired pneumonia has a major impact in terms of mortality and morbidity.

• Empirical treatment approach is still the best course of action.

• Prevention is of critical importance.

Educational aims

• To improve knowledge of HAP management.

• To better understand the epidemiological basis for the correct empirical therapy of HAP

Summary HAP still has a major impact in terms of mortality and morbidity among hospitalised patients. Early appropriate antibiotic therapy is associated with a reduction in mortality and improved outcome. Although, in most cases, an empirical approach is still the rule, taking into account the risk factors, the severity of illness and length of stay before the pneumonia onset can better target antibiotic therapy. The patient's follow-up course, in terms of microbiological, clinical and radiological monitoring, is important. Prevention strategies are of critical importance and are based on the understanding of the epidemiology and pathogenesis of HAP. Routine efforts for the prevention of HAP should be directed towards obtaining effective surveillance and infection-control programmes, including staff education, use of proper isolation techniques and infection-control practices. This review aims to increase understanding of these points to allow improved knowledge and treatment of HAP.