Vienna, 28–29 February 2008

A meeting primarily for intensivists but also for clinical microbiologists and infectious disease specialists with an interest in intensive care medicine was held in Vienna recently. Although not an AIM event, Robert Masterton and Gilbert Park from the AIM core faculty formed part of the international expert faculty for this meeting. The meeting included plenary presentations, debates, ‘Ask the Experts’ sessions and patient case study workshops, with a strong emphasis on interaction between the delegates and the faculty. The two patient case studies were specially developed for the meeting and their format followed that of case studies included on the AIM website. The first of which is our new case study for this month.

A young woman is involved in a road traffic accident in which she sustains a head injury and broken bones. She requires mechanical ventilation and unfortunately, she develops ventilator-associated pneumonia. Follow her clinical course and decide how you would manage this patient. This case will really test your knowledge of appropriate antibiotic use!

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Review by Marin H Kollef
University School of Medicine, St Louis, Missouri, USA

Empiric antibiotic therapy for suspected ventilator-associated pneumonia: a systematic review and meta-analysis of randomized trials.
Aarts M-AW, Hancock JN, Heyland D, et al. Crit Care Med 2008;36:108–117.

Ventilator-associated pneumonia (VAP) is a major cause of morbidity and mortality worldwide among hospitalised patients and several studies have shown that inappropriate initial antimicrobial therapy and delayed appropriate treatment of VAP are associated with greater morbidity and hospital mortality. In this summary, Marin Kollef examines this meta-analysis and review of several randomised studies, which concluded that – unlike many other analyses – the type of therapy did not influence outcomes in patients with VAP. Professor Kollef gives his view of the topic, why the authors may have come to this conclusion, and considers why not all meta-analyses are the same. This review highlights numerous important aspects that should be borne in mind when evaluating the results of studies on appropriate therapy in VAP and other serious infections.

   Read this Paper of the Month

We are very pleased to share with you two final presentations from the 5th AIM Global Summit Meeting, which includes the very latest and the most relevant data on infection management issues. This presentation was given by Tobias Welte, entitled ‘Update on ventilator-associated pneumonia’ and Marin H Kollef, entitled ‘Quantitative cultures to diagnose VAP: How much quantitation?’

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