Recent advances in the treatment of pneumonia in the intensive care unit.

The treatment of pneumonia acquired in the intensive care unit (ICU) includes intravenous antibiotics and supportive care. In many cases, the aetiologic agent of infection is not clear and empirical broad-spectrum antibiotic regimens are commonly used. Combinations of beta-lactam and aminoglycoside agents are particularly popular due to the high incidence of Gram-negative bacillary and Staphylococcus aureus pneumonias in the hospital setting. Several new approaches to treatment of pneumonia in the ICU are currently being evaluated including single-agent empirical treatment with broad-spectrum beta-lactam agents; intrabronchial aminoglycoside instillation therapy; oral quinolone agents for treatment of Gram-negative bacillary pneumonia; and passive immune therapy. Conventional and experimental therapy are discussed in this report.