Antibiotics for Ventilator-Associated Tracheobronchitis
Author Information
Author(s): Nseir Saad, Favory Raphaël, Jozefowicz Elsa, Decamps Franck, Dewavrin Florent, Brunin Guillaume, Di Pompeo Christophe, Mathieu Daniel, Durocher Alain, the VAT Study Group
Primary Institution: CHRU de Lille
Hypothesis
In patients with VAT, antibiotic treatment would be associated with reduced duration of mechanical ventilation.
Conclusion
In patients with VAT, antimicrobial treatment is associated with a greater number of days free of mechanical ventilation and lower rates of VAP and ICU mortality.
Supporting Evidence
- Mechanical ventilation-free days were significantly higher in the antibiotic group than in the no antibiotic group.
- Subsequent VAP rates were significantly lower in the antibiotic group.
- ICU mortality rates were significantly lower in the antibiotic group.
Takeaway
Giving antibiotics to patients with a lung infection while on a ventilator helps them spend more days off the ventilator and reduces the chances of getting worse infections.
Methodology
A prospective, randomized, controlled, unblinded, multicenter study where patients were assigned to receive or not receive intravenous antibiotics for 8 days.
Potential Biases
The study was not blinded, and antibiotic treatment was not standardized across all patients.
Limitations
The trial was stopped early due to significant differences in ICU mortality, leading to an imbalance in group sizes and potential type I error.
Participant Demographics
Patients were adults over 18 years old with a first episode of VAT diagnosed more than 48 hours after starting mechanical ventilation.
Statistical Information
P-Value
P < 0.001 for mechanical ventilation-free days; P = 0.011 for subsequent VAP; P = 0.047 for ICU mortality.
Confidence Interval
OR 0.17 (95% CI 0.04 to 0.70) for subsequent VAP; OR 0.24 (95% CI 0.07 to 0.88) for ICU mortality.
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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