Intensive Care Medicine

, Volume 35, Issue 1, pp 9–29 | Cite as

Defining, treating and preventing hospital acquired pneumonia: European perspective

  • Antoni TorresEmail author
  • Santiago Ewig
  • Harmut Lode
  • Jean Carlet
  • For The European HAP working group
Special Article



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.

Materials and methods

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.


Hospital acquired pneumonia Ventilator-associated pneumonia Ventilation-acquired pneumonia Nosocomial pneumonia 



Centre for diseases control


Hospital acquired pneumonia


ICU acquired pneumonia


Ventilation-acquired pneumonia


Acute respiratory distress syndrome


European Respiratory Society


European Society of Intensive Care Medicine


European Society of Clinical Microbiology and Infectious Diseases


American Thoracic Society


Hospital in Europe link for infection control through surveillance


Broncho alveolar lavage


Protected specimen brush


Tracheo bronchial aspirates


C Reative protein




Clinical pulmonary infection score


Selective digestive decontamination


Intensive care unit


Long term care facilities


Nursing homes


Length of stay


Methicillin resistant Staphylococcus aureus


Extended spectrum β lactamases


Odd ratio


Risk ratio


Randomized clinical trials



This Task Force was supported and funded by ERS, ESCMID and ESICM.


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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Antoni Torres
    • 1
    Email author
  • Santiago Ewig
    • 2
  • Harmut Lode
    • 3
  • Jean Carlet
    • 4
  • For The European HAP working group
  1. 1.Cap de Servei de Pneumologia i Al·lèrgia Respiratòria. Institut Clínic del TòraxHospital Clínic de Barcelona, Universitat de Barcelona. IDIBAPS.CIBERES 06/06/0028.BarcelonaSpain
  2. 2.Thoraxzentrum Ruhrgebiet, Kliniken für Pneumologie und InfektiologieEv. Krankenhaus Herne und Augusta-Kranken-Anstalt BochumBochumGermany
  3. 3.Hospital Heckeshorn, Chest and Infectious DiseasesBerlinGermany
  4. 4.Groupe Hospitalier Paris Saint JosephParisFrance

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