Delayed Antibiotic Therapy in Non-severe Ventilator Acquired Pneumonia (VAP)

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

87 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-01-06

Study Completion Date

2023-01-28

Brief Summary

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This retro-prospective monocentric observational study compare the impact of the implementation of a restrictive (delayed) versus aggressive (immediate) antibiotic strategy for Ventilator Acquired Pneumonia suspicion without severity symptoms.

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Detailed Description

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Ventilator acquired pneumonia (VAP) is the leading cause of nosocomial infection in intensive care patients, and has been associated with increased antibiotic consumption, increased morbidity and mortality. VAP diagnosis is difficult due to subjective or non-specific criteria. Delaying antibiotic treatment for VAP suspicion without severity symptoms raises question since the probability of VAP diagnosis, as well as the risk of delaying treatment, is very uncertain. It may nonetheless limit the environmental impact of antibiotic use which is a public health concern. We compared antibiotic sparing and patient outcome, before and after the implementation of a restrictive (delayed) antibiotic strategy versus an aggressive (immediate) antibiotic strategy in VAP suspicion without severity symptoms.

Conditions

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Ventilator Associated Pneumonia Critical Care Antibiotic Therapy

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

OTHER

Study Groups

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Restrictive antibiotic strategy

Intervention Type OTHER

Implementation of a restrictive (delayed) antibiotic strategy in Ventilator Acquired Pneumonia suspicion without severity symptoms.

Aggressive (immediate) antibiotic strategy

Aggressive antibiotic strategy

Intervention Type OTHER

Implementation of an aggressive (immediate) antibiotic strategy in Ventilator Acquired Pneumonia suspicion without severity symptoms.

Interventions

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Restrictive antibiotic strategy

Implementation of a restrictive (delayed) antibiotic strategy in Ventilator Acquired Pneumonia suspicion without severity symptoms.

Intervention Type OTHER

Aggressive antibiotic strategy

Implementation of an aggressive (immediate) antibiotic strategy in Ventilator Acquired Pneumonia suspicion without severity symptoms.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Under mechanical ventilation from more than 48 hours
* Suspected for a ventilator acquired pneumonia, requiring a distal pulmonary bacterial sample

Exclusion Criteria

* New or worsening shock requiring vasopressor
* New or worsening severe hypoxemia (PaO2/FiO2\<150 in FiO2≥60% and peep 10)
* Patient under veno-veinous extracorporeal membrane oxygenation
* Neutropenia \<1G/L or immunosuppressive treatment (including corticosteroids \>6 months or \>0.5mg/kg/j)
* Disease (endocarditis, spondylodyscitis, deep abcedation…) requiring prolonged antibiotic therapy

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No