Although more prospective therapy trials of Hospital-acquired Pneumonia (HAP) are needed, based on currently available data, it is possible to use an approach that provides appropriate therapy without the overuse of broad-spectrum therapy. HAP can arise out of the ICU, or in the ICU, and can lead to severe illness, including the need for intubation and mechanical ventilation. New American and European nosocomial pneumonia guidelines make therapy recommendations for HAP. The American guidelines recommend broader spectrum therapy than the European guidelines, but recent studies support the idea that not all HAP patients need antipseudomonal therapy.

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