In treating hospital-acquired and ventilator-associated pneumonia with no risks, which option is recommended?

The appropriate treatment for hospital-acquired and ventilator-associated pneumonia, particularly in cases where there are no specific risk factors present, is to use one anti-Pseudomonas agent. This approach is grounded in evidence-based guidelines that recommend coverage for Pseudomonas aeruginosa due to its prevalence in these types of infections, but it does not necessitate the use of multiple agents when the risk for worse outcomes is low.

The rationale behind recommending a single anti-Pseudomonas agent lies in balancing the need for effective coverage against unnecessary broad-spectrum antibiotic use, which can contribute to resistance and other complications. In the context of pneumonia, pathogens can vary significantly, and while coverage for MRSA or a broader range of Gram-negative organisms may be warranted in certain high-risk scenarios, the absence of such risks allows for a more streamlined approach.

The other options suggest more complex treatment regimens that may not be justified without specific risk factors—using multiple agents can lead to increased side effects and the potential for antibiotic resistance, which is a growing concern in clinical practice.