Defining, treating and preventing hospital acquired pneumonia: European perspective

Many controversies still remain in the management of hospital acquired pneumonia (HAP), and ventilation-acquired pneumonia (VAP), Three European Societies, European Respiratory Society (ERS), European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and European Society of Intensive Care Medicine (ESICM), were interested in producing a document on HAP and VAP with European perspective. The scientific committees from each Society designated one chairman; Antoni Torres (ERS), Harmut Lode (ESCMID) and Jean Carlet (ESICM). The chairmen of this Task Force suggested names from each Society to be a member of the panel. They also choose controversial topics on the field and others that were not covered by the last IDSA/ATS guidelines. Each topic was assigned to a pair of members to be reviewed and written. Finally, the panel defined 20 consensual points that were circulated several times among the members of the panel until total agreement was reached. A combination of evidences and clinical-based medicine was used to reach these consensus. This manuscript reviews in depth several controversial or new topics in HAP and VAP. In addition 20 consensual points are presented. This manuscript may be useful for the development of future guidelines and to stimulate clinical research by lying out what is currently accepted and what is unknown or controversial.