Current concepts in ventilator-associated pneumonia.

Ventilator-associated pneumonia (VAP) is a common problem in the intensive care unit (ICU). It is associated with a distinct spectrum of pathogens and its pathogenesis involves microaspiration of oropharyngeal organisms. Clinical and radiographic criteria have been shown to be unreliable in diagnosing VAP, and it remains a challenge for intensivists to utilise the array of diagnostic procedures at their disposal to optimise diagnostic accuracy (improve specificity) and guide in therapy. These procedures and guided antibiotic therapy may not always improve the outcome and therefore simple preventive measures should be employed to reduce the incidence.