Clinical practice guidelines for hospital-acquired and ventilator-associated pneumonia: A scoping review

OBJECTIVES: Healthcare-associated pneumonia (HAP), particularly ventilator-associated pneumonia (VAP), remains a major clinical challenge due to its prevalence, mortality, and diagnostic and therapeutic complexity. This study aimed to summarize the characteristics and reliability of clinical practice guidelines (CPGs) for the diagnosis and management of HAP and VAP. METHODS: A scoping review was conducted on CPGs published or updated from 2015 to February 2025 based on systematic reviews. Searches were performed in PubMed, Trip Database, the Guidelines International Network, Epistemonikos, Google, and Google Scholar. Two reviewers independently selected and extracted data. The AGREE II tool assessed CPG quality, and recommendations were compared across overlapping topics. RESULTS: Six CPGs were identified. All used the GRADE approach, but only three included a Summary of Findings (SoF) table, and none applied the Evidence to Decision (EtD) framework. Four achieved an AGREE-II overall score ≥70%. Fourteen key topics were identified; in eight, recommendations were consistent, in five, they varied, and in one, they were contradictory. CONCLUSIONS: CPGs for HAP and VAP showed notable variability in methodological rigor and recommendations. Limited use of SoF tables and EtD frameworks reduced transparency, highlighting the need for improved guideline development to support evidence-based practice.