Health-care associated pneumonia: review of published evidence

Abstract

The concept of health-care-associated pneumonia (HCAP) arose from the presumption that the pathogens that cause the disease would be more likely to be multi-resistant microorganisms (MRMO), so the antibiotic treatment scheme should be different from the one required in community acquired pneumonia (CAP). However, the evidence supporting this idea is not robust enough. Given the complexity of the topic, and its high impact on the exaggerated consumption of antibiotics, this review is presented. It is possible that the absence of risk factors usually described, or the presence of only one, suggests a low probability of MRMO, so the therapeutic approach should be similar to that of CAP. On the contrary, in view of the accumulation of risk factors or in severe cases, MRMO coverage could be considered, through an extended spectrum scheme.