The place of guidelines in hospital-acquired pneumonia.

The recent increase in hospital-acquired infections (HAIs) has meant that hospital-acquired pneumonia (HAP) has come under the spotlight. HAP is the most common HAI contributing to death and affects about 0.5-1% of all patients admitted to hospital. HAP significantly increases health complications and extends the length of time patients stay in hospital by up to 13 days on average, thus impacting significantly on hospital resources. The British Society of Antimicrobial Chemotherapy Hospital-Acquired Pneumonia guidelines were published on the society's website last year and represent one of only two sets of evidence-based HAP guidelines in the world which deal with the trio of prevention, diagnosis and treatment. This paper reviews the evolution and status of HAP guidelines, drawing attention to recent developments, differences in approach and outcomes and further areas of work. There are clear indications that the implementation of evidence-based guidelines will reduce HAP and improve patient outcomes.