Tuesday October 11, 2005
VAP, HAP and HCAP
Beside VAP (Ventilator-associated Pneumonia) - it is important to know 2 other terms HAP (Hospital-acquired Pneumonia) and HCAP (Healthcare-associated Pneumonia) as it may influence choice of antibiotics in early management as risk factors for MDR pathogens may be high.
HAP is pneumonia either 1) early onset that occurs within 4 days (Anbx sensitive) or 2) late onset that occurs after 4 days of hospitalization (risk for MDR pathogens).
HCAP is pneumonia that occurs 1) hospitalization for 2 days or more in the preceding 90 days or 2) residence in Nursing home or any extended care facility or 3) Home infusion therapy or 4) long term dialysis within 30 days or 5) Home wound care or 6) Family member with MDR pathogen or 7) Antibiotics in last 90 days or 8) immunosuppressive disease / therapy.
Guidelines for the Management of Adults with Hospital-acquired, Ventilator-associated, and Healthcare-associated Pneumonia: Am. J. Respir. Crit. Care Med. 2005; 171: 388-416