Hospital-Acquired Pneumonia. Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) Guidelines. 2019 Update.

Hospital-acquired pneumonia (HAP) is the second leading cause of nosocomial infection, and increases morbidity and mortality. It is currently classified into three groups: HAP not requiring artificial ventilation, HAP requiring artificial ventilation, and HAP acquired during artificial ventilation, also known as ventilator-acquired pneumonia (VAP). The latest guidelines for the management of HAP were published in 2016 (IDSA/ATS) and 2017 (ERS/ESCMID/ESICM and ALAT). The latest Spanish guidelines were published in Archivos de Bronconeumologia in 2011. American guidelines from 2016 and international guidelines from 2017 present their recommendations in a context of significantly increased resistance of both Gram-positive and, in particular, Gram-negative microorganisms to antibacterial agents. In 2019, SEPAR celebrated Pneumonia Year, and we felt that this was an appropriate time to update the guidelines published in 2011. Pulmonologists, intensive care specialists, infectious disease specialists, and methodology experts participated in drawing up this document, and agreed to use the following scheme.