Mechanical ventilation: Antibiotic prophylaxis decreases respiratory tract infection and mortality in critically ill patients
Clinical Bottom Line
- Antibiotic prophylaxis decreases the incidence of respiratory tract infection and mortality in critically ill patients requiring mechanical ventilation.
- Prophylaxis with topical antibiotics alone decreases the incidence of respiratory tract infection in critically ill patients requiring mechanical ventilation, but does not decrease mortality.
Effectiveness of antibiotic prophylaxis in critically ill adult patients: systematic review of randomised controlled trials. BMJ 1998;316:1275-85.
In critically ill patients requiring mechanical ventilation, does prophylactic antibiotics reduce the risk of respiratory tract infection?
"Critical care", "Antibiotics", "Respiratory tract infections" in Medline
Systematic review of RCTs that studied topical plus systemic antibiotics versus no treatment and topical preparations with or without systemic antibiotics versus a systemic agent or placebo in unselected critically ill adult patients with outcomes of respiratory tract infections or death.
|Intervention||Outcome||CER (weighted)||EER (weighted)||RRR||ARR (weighted) [95% CI]||NNT [95% CI]|
|Systemic and Topical Antibiotic||Respiratory Tract Infection||.36||.16||.56||.20 [.20 - .25]||5 [4 - 5]|
|Mortality||.30||.24||.20||.06 [.01 - .07]||23 [14 - 68]|
|Topical Antibiotic||Respiratory Tract Infection||.28||.18||.36||.10 [.08 - .14]||9 [7 - 13]|
- The treatment effect is consistent across type of patient (medical, surgical, or trauma and APACHE II stratification.
- No significant difference in pooled data from individual patients v. aggregate data.
- Review does not allow a unique antibiotic regimen to be chosen.
Created by Berenholtz S, Pronovost P
Pronovost P, 1999