Evaluation of treatment protocol of ventilator-associated pneumonia in pediatric intensive care unit of Assiut University Children Hospital (clinical audit)

Background
Ventilator-associated pneumonia (VAP) is a hospital-acquired pneumonia that occurs in patients who have been linked to mechanical ventilation for more than or equal to 48 h without symptoms or signs of infection of the lower respiratory tract before connection to mechanical ventilation.
Aim

Results
The study included 50 cases admitted in PICU at Assiut University Children Hospital who developed VAP. There were 32 males and 18 females with age ranging from 1 month to 17 years. VAP was detected more commonly among age group 1 month to less than 5 years (76%) followed by age group 5 to less than 10 years (16%) followed by age group 10 to 17 years (8%). Late-onset VAP was observed in 86% of cases, while early-onset VAP was observed in 14% of cases. VAP with risk factors for resistant organisms was observed in 94% of cases, while VAP without risk for resistant organisms was observed in 6% of cases. In our study, the treatment that was given for the studied cases was in the form of empirical therapy. According to the American Protocol of Management, VAP in PICU was given in 86% of cases. Changing antimicrobial therapy after 48–72 h according to culture results and clinical response was done in 78% of cases. Proper broad-spectrum empirical therapy and de-escalation of antibiotics according to culture results and clinical response was done in 76% of cases.
Conclusion
The PICU team of Assiut University Children Hospital follows the American guidelines of treatment of VAP in 76% of cases that were admitted during the period of the study.