Antimicrobial Resistance Fighter Coalition - SHEA Guidelines

Prevention of HAIs

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Intervention • Use noninvasive positive pressure ventilation in selected populations (I) • Minimize the duration of mechanical ventilation (I) • Assess readiness to extubate daily (III) • Manage patients without sedation whenever possible (III) • Avoid unplanned extubation (III) • Provide regular oral care with sterile water (III) • Minimize breaks in the ventilator circuit (III) • Change the ventilator circuit only if visibly soiled or malfunctioning (III) • Lateral recumbent positioning (III) • Reverse Trendelenburg positioning (III) • Closed/in-line suctioning systems (III) • Regular oral care with antiseptics (III) • Histamine 2 receptor antagonists (II) • Prophylactic broad-spectrum antibiotics (II) • Daily spontaneous breathing trials (III) • Daily sedative interruptions (III) • Prophylactic probiotics or synbiotics (III) • Endotracheal tubes with subglottic secretion drainage ports (NA) • Silver-coated endotracheal tubes (NA) 23

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