Nosocomial or Healthcare Facility-Related Pneumonia in Adults.

Nosocomial or hospital-acquired pneumonia (HAP) is a dynamic disease with multiple etiologic agents and a changing natural history. The emergence and spread of multidrug-resistant bacterial pathogens is a current concern. Because of the parallels between HAP and pneumonia occurring in patients in subacute or chronic care facilities, we suggest the use of a more inclusive term for these patients: healthcare facility-related pneumonia. This article focuses on current controversies in the pathogenesis, diagnosis, management, and prevention of bacterial HAP in adults. We endorse early, appropriate antibiotic therapy based on disease severity and the use of strategies to prevent infection, improve patient outcome, and reduce hospital costs.