Does ventilator-associated tracheobronchitis need antibiotic treatment.docVIP

Available online /content/9/3/255 Commentary Does ventilator-associated tracheobronchitis need antibiotic treatment? Antonio Torres1 and Mauricio Valencia2 1Chairman, Department of Pulmonology and Critical Care, Hospital Clinic, IDIBAPS, Facultat de Medicina, Universitat de Barcelona, Red Gira and Red Respira, Barcelona, Spain 2Critical Care Researcher, Department of Pulmonology and Critical Care, Hospital Clinic, IDIBAPS, Facultat de Medicina, Universitat de Barcelona, Red Gira and Red Respira, Barcelona, Spain Corresponding author: Antonio Torres, atorres@clinic.ub.es Published online: 3 May 2005 Critical Care 2005, 9:255-256 (DOI 10.1186/cc3535) This article is online at /content/9/3/255 ? 2005 BioMed Central Ltd See related research by Nseir et al. in this issue [/content/9/3/R238] Abstract However, we have no doubt that this entity exists from the clinical point of view. This belief results from the findings of post-mortem studies [3], in which it is not infrequent to find high bacterial counts in lung samples without histological It is difficult to define ventilator-associated tracheobronchitis (VAT). The most accepted definition includes fever (temperature 38°C), new or increased sputum production, a microbiologically positive respiratory sample with counts above the accepted thresholds and absence of pulmonary infiltrates on chest X-ray. Although we have no doubt that this pathologic process exists, the main controversy lies on whether this entity has any impact on the outcome and, thus, a specific therapeutic approach is suitable. We will discuss the strengths and drawbacks of the article on this topic published in this issue by Nseir et al. pneumonia. In addition, some years ago Rouby and coworkers [4] described the existence of bronchiolitis without histological mechanically pneumonia ventilated in patients lung samples shortly taken after from death. Establishing comparisons with