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Effect of antibiotics administered via the respiratory tract in the prevention of ventilator-associated pneumonia: A systematic review and meta-analysis.
Póvoa, Frederico Castro Costa; Cardinal-Fernandez, Pablo; Maia, Israel Silva; Reboredo, Maycon Moura; Pinheiro, Bruno Valle.
Afiliação
  • Póvoa FCC; Pulmonary and Critical Care Division, University Hospital of Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil.
  • Cardinal-Fernandez P; Emergency Department, Hospital Universitario HM Sanchinarro, Madrid, Spain; HM Research Foundation, Spain.
  • Maia IS; General Medicine Department, Health Sciences Center, Hospital Universitário da Universidade Federal de Santa Catarina, Florianópolis, Brazil.
  • Reboredo MM; Pulmonary and Critical Care Division, University Hospital of Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil.
  • Pinheiro BV; Pulmonary and Critical Care Division, University Hospital of Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil. Electronic address: bruno.pinheiro@ufjf.edu.br.
J Crit Care ; 43: 240-245, 2018 Feb.
Article em En | MEDLINE | ID: mdl-28942198
PURPOSE: We evaluated the effect of antibiotics administered via the respiratory tract to prevent the ventilator-associated pneumonia (VAP) in mechanically ventilated (MV) patients. METHODS: We searched relevant articles for trials that evaluated the impact of prophylactic antibiotics administered through the respiratory tract on the occurrence of VAP. The end-point was the occurrence of VAP in MV patients. RESULTS: We included 6 comparative trials involving 1158 patients (632 received prophylactic antibiotic). Our meta-analysis revealed that prophylactic antibiotics administered through the respiratory tract reduced the occurrence of VAP when compared to placebo or no treatment (OR 0.53; 95% CI 0.34-0.84). This effect was seen when the antibiotics were given by nebulization (OR 0.46; 95% CI 0.22-0.97), but not when they were administered by intratracheal instillation (OR 0.57; 95% CI 0.28-1.15). We did not find a significant difference between the compared groups in the intensive care unit (ICU) mortality (OR 0.89; 95% CI 0.64-1.25). Antibiotic prophylaxis did not impact occurrence of VAP due to multidrug resistant (MDR) pathogens (OR 0.67; 95% CI 0.17-2.62). CONCLUSIONS: Prophylactic antibiotics administered through the respiratory tract by nebulization reduce the occurrence of VAP, without a significant effect on either the ICU mortality or occurrence of VAP due to MDR pathogens.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pneumonia Associada à Ventilação Mecânica / Antibacterianos Tipo de estudo: Clinical_trials / Risk_factors_studies / Systematic_reviews Limite: Humans Idioma: En Revista: J Crit Care Assunto da revista: TERAPIA INTENSIVA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pneumonia Associada à Ventilação Mecânica / Antibacterianos Tipo de estudo: Clinical_trials / Risk_factors_studies / Systematic_reviews Limite: Humans Idioma: En Revista: J Crit Care Assunto da revista: TERAPIA INTENSIVA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos