Monday, January 12, 2015

Rethinking the Prevention of Ventilator Associated Pneumonia

Ventilator associated pneumonia (VAP) is the least common yet the most dangerous of hospital acquired, device associated infections.

Selective digestive decontamination (SDD) works for the prevention of VAP. Many infectious diseases, including myself, have an aversion to prescribing antibiotics for preventive measures, largely owing to the fear of selecting antibiotic resistant organisms. For many, this is dogma. 

This recent paper, a systematic review and meta-analysis published in Clinical Infectious Diseases, summarizes much of the data in VAP prevention and challenges our hang ups. Current data suggests that SDD is one of the most effective measures to prevent VAP and reduce mortality.

We must rethink our objections to SDD for VAP prevention and push ourselves to study both the short and long term benefits of digestive decontamination. 

Interventions should be guided by data. Data trumps dogma. 

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