Clinically, there is justified debate over the utility of the
health care-associated pneumonia criteria. A survey of physicians
responsible for choosing initial antibiotic therapy
reports that 79% of participants agree with and practice
according to published health care-associated pneumonia
guidelines, yet guideline-concordant health care-associated
pneumonia therapy was selected in only 9% of health careassociated
pneumonia clinical scenarios.32 These findings,
coupled with the poor predictive value of health care-associated
pneumonia criteria, question the value of health careassociated
pneumonia as a distinct clinical entity and suggest
that an overhaul of current recommendations may be
appropriate