Impact of Gram stain results on initial treatment selection in patients with ventilator-associated pneumonia: a retrospective analysis of two treatment algorithms - Impact of Gram stain results on initial treatment selection in patients with ventilator-associated pneumonia: a retrospective analysis of two treatment algorithms

Antimicrobial choices proposed by the Guideline based algorithm and the Gram stain based algorithm were appropriate in 94.7% and 92.4% of cases, respectively. McNemar's test showed no significant difference in adequacy for the different strategies (p = 0.221). The Gram stain based algorithm proposed anti-methicillin-resistant Staphylococcus aureus agents in significantly fewer episodes than the Guideline based algorithm (41 (31.3%) versus 92 (70.2%), respectively (p < 0.001)). The Gram stain based algorithm also recommended antipseudomonal agents in significantly fewer episodes than the Guideline based algorithm (68 (51.9%) versus 92 (70.2%), respectively (p < 0.001)).