Guidelines for preventing health-care-associated pneumonia, 2003: buyer beware!

Nosocomial pneumonia is an important concern for patients, clinicians, health care executives, and third-party payers. The Centers for Disease Control (CDC) published the first CDC guidelines addressing infection control problems in 1981. These guidelines were revised and expanded in 1994 and are an important guide to develop hospital infection control practices.1 Since the publication of the 1994 CDC guidelines, additional high-level studies, evidence-based reviews, and evidence-based guidelines have been published. With this added evidence there was much anticipation for the revised CDC guidelines recently published2 and parts of which are reprinted in this issue of RESPIRATORY CARE. These revised guidelines have, unfortunately, raised important questions that limit their credibility and applicability. I have serious concerns about these guidelines, related to their methodology, validity, and relevancy, that raise questions regarding their usefulness.