[Recommendations for the treatment of severe nosocomial pneumonia].

Delay in initiating appropriate antibiotic treatment in patients with severe nosocomial pneumonia (SNP) is associated with a more unfavorable prognosis,1-6 longer hospital stays, and consequently higher healthcare costs. Moreover, in the context of ventilator-associated pneumonia (VAP), changing inappropriate empiric antibiotic regimens after the causative pathogen has been isolated does not significantly improve the initial unfavorable prognosis.1,2 It would, therefore, seem clear that the choice of an appropriate empiric antibiotic regimen is one of the few factors predicting mortality in cases of SNP that can be modified. On the other hand, it should be remembered that the indiscriminate use of antibiotics and excessively long antimicrobial treatments can lead to the emergence of multiresistant flora and therefore have negative repercussions on the antibiotic policies of hospitals.