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Ventilator-Associated Pneumonia — SCE Infectious Diseases MCQ

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ModerateHealthcare-Associated InfectionsVentilator-Associated PneumoniaSCE Infectious Diseases

A 70-year-old man in the ICU develops ventilator-associated pneumonia (VAP) on day 8 of mechanical ventilation. He received Piperacillin/Tazobactam for community-acquired pneumonia on admission. Tracheal aspirate culture grows Pseudomonas aeruginosa sensitive to Meropenem, Ceftazidime, and Ciprofloxacin but resistant to Piperacillin/Tazobactam. What is the recommended duration of treatment for VAP?

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Correct answer: E — 7 days

The recommended treatment duration for ventilator-associated pneumonia (VAP) is 7 days, provided there is an adequate clinical response. This applies even when the pathogen is Pseudomonas aeruginosa; the culture result determines the choice of an active antipseudomonal antibiotic, not a routine extension of duration. In this case, piperacillin/tazobactam should not be used because the isolate is resistant, and treatment should be directed to a susceptible agent such as meropenem or ceftazidime according to local ICU/microbiology advice. Longer courses such as 10–14 days are not routine for VAP and are reserved for complications or poor clinical response.

Reference: ATS/IDSA Clinical Practice Guidelines for the Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia, 2016: recommends a 7-day course of antimicrobial therapy for VAP rather than a longer duration. https://www.idsociety.org/practice-guideline/hap_vap/