{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:04:23Z","timestamp":1790611463450,"version":"4.1.0"},"reference-count":118,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,3,8]],"date-time":"2022-03-08T00:00:00Z","timestamp":1646697600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Ventilator-associated pneumonia is a frequent cause of ICU-acquired infections. These infections are associated with high morbidity and mortality. The increase in antibiotic resistance, particularly among Gram-negative bacilli, makes the choice of empiric antibiotic therapy complex for physicians. Multidrug-resistant organisms (MDROs) related infections are associated with a high risk of initial therapeutic inadequacy. It is, therefore, necessary to quickly identify the bacterial species involved and their susceptibility to antibiotics. New diagnostic tools have recently been commercialized to assist in the management of these infections. Moreover, the recent enrichment of the therapeutic arsenal effective on Gram-negative bacilli raises the question of their place in the therapeutic management of these infections. Most national and international guidelines recommend limiting their use to microbiologically documented infections. However, many clinical situations and, in particular, the knowledge of digestive or respiratory carriage by MDROs should lead to the discussion of the use of these new molecules, especially the new combinations with beta-lactamase inhibitors in empirical therapy. In this review, we present the current epidemiological data, particularly in terms of MDRO, as well as the clinical and microbiological elements that may be taken into account in the discussion of empirical antibiotic therapy for patients managed for ventilator-associated pneumonia.<\/jats:p>","DOI":"10.3390\/antibiotics11030359","type":"journal-article","created":{"date-parts":[[2022,3,8]],"date-time":"2022-03-08T12:35:37Z","timestamp":1646742937000},"page":"359","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Empiric Treatment in HAP\/VAP: \u201cDon\u2019t You Want to Take a Leap of Faith?\u201d"],"prefix":"10.3390","volume":"11","author":[{"given":"Khalil","family":"Cha\u00efbi","sequence":"first","affiliation":[{"name":"D\u00e9partement de R\u00e9animation M\u00e9dico-Chirurgicale, AP-HP H\u00f4pital Avicenne, Universit\u00e9 Sorbonne Paris Nord, 93000 Bobigny, France"},{"name":"Common and Rare Kidney Diseases, Sorbonne Universit\u00e9, INSERM, UMR-S 1155, 75020 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gauthier","family":"P\u00e9an de Ponfilly","sequence":"additional","affiliation":[{"name":"Service de Microbiologie Clinique, Groupe Hospitalier Paris Saint-Joseph, 75014 Paris, France"},{"name":"Institut Micalis, Unit\u00e9 Mixte de Recherche 1319, Universit\u00e9 Paris-Saclay, INRAe, AgroParisTech, 92290 Ch\u00e2tenay Malabry, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6596-7384","authenticated-orcid":false,"given":"Laurent","family":"Dortet","sequence":"additional","affiliation":[{"name":"Service de Bact\u00e9riologie-Hygi\u00e8ne, CHU de Bic\u00eatre, Assistance Publique des H\u00f4pitaux de Paris, Centre National de R\u00e9f\u00e9rence de la R\u00e9sistance aux Antibiotiques, 94270 Le Kremlin-Bic\u00eatre, France"},{"name":"INSERM UMR1184, Resist Unit, Universit\u00e9 Paris-Saclay, 94270 Le Kremlin-Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Ralph","family":"Zahar","sequence":"additional","affiliation":[{"name":"Infection Control Unit, AP-HP H\u00f4pital Avicenne, Universit\u00e9 Sorbonne Paris Nord, 93000 Bobigny, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beno\u00eet","family":"Pilmis","sequence":"additional","affiliation":[{"name":"Institut Micalis, Unit\u00e9 Mixte de Recherche 1319, Universit\u00e9 Paris-Saclay, INRAe, AgroParisTech, 92290 Ch\u00e2tenay Malabry, France"},{"name":"\u00c9quipe Mobile de Microbiologie Clinique, Groupe Hospitalier Paris Saint-Joseph, 75014 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1700582","DOI":"10.1183\/13993003.00582-2017","article-title":"International ERS\/ESICM\/ESCMID\/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia: Guidelines for the management of hospital-acquired pneumonia (HAP)\/ventilator-associated pneumonia (VAP) of the European Respiratory Society (ERS), European Society of Intensive Care Medicine (ESICM), European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and Asociaci\u00f3n Latinoamericana del T\u00f3rax (ALAT)","volume":"50","author":"Torres","year":"2017","journal-title":"Eur. 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