A sub-group of patients with hospital-acquired pneumonia do not require broad-spectrum gram-negative antimicrobial coverage.

Amongst 200 patients developing HAP outwith the ICU, 61% were treated empirically without broad-spectrum gram-negative coverage, with clinical cure in 69.7%. Lower disease severity markers(SIRS, hypoxia, tachypnoea, neutrophilia) and absence of diabetes mellitus and prior doxycycline treatment (but not time to HAP onset) identified patients not requiring broad-spectrum gram-negative coverage.