RESPIRATORY INFECTIONS: Edited by Michael S. NiedermanDuration of therapy of ventilator-associated pneumoniaDimopoulos, George; Matthaiou, Dimitrios K.Author Information Department of Critical Care, Attikon University Hospital, University of Athens, Medical School, Athens, Greece Correspondence to George Dimopoulos, Department of Critical Care Medicine, Attikon University Hospital, University of Athens, 1 Rimini Str., 124 62 Haidari, Greece. Tel: +30 210 583 2182; fax: +30 210 583 2182; e-mail: [email protected] Current Opinion in Infectious Diseases: April 2016 - Volume 29 - Issue 2 - p 218-222 doi: 10.1097/QCO.0000000000000245 Buy Metrics Abstract Purpose of review Ventilator-associated pneumonia (VAP) is a major cause of morbidity and mortality in the critical care setting. It incurs great additional cost and the antibiotics prescribed for patients with VAP account for the majority of total antibiotic prescriptions. The increased cost of VAP as well as the emergence of antimicrobial resistance and the potential adverse events because of treatment indicate that the application of shorter antibiotic regimens for the treatment of VAP poses as a one-way choice. Recent findings According to the findings of relevant randomized controlled trials, patients receiving short-course regimens for the treatment of VAP have significantly more antibiotic-free days without any negative impact on mortality. Additionally, no other differences were found regarding other secondary outcomes. However, there were higher relapse rates in patients with VAP because of nonfermenting Gram-negative bacilli and there was a lower emergence of multidrug-resistant pathogens. Summary The shortening of the duration of treatment for VAP is promising, as long as a holistic approach that combines methods ensuring the adequate sterilization of septic foci, the optimization of antibiotic levels, the multifaceted delivery of antimicrobials in the lung and the usage of biomarkers that allow the monitoring of the disease course and the effectiveness of administered treatment are incorporated in clinical practice. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.