ArticleIntensive care medicine2009
Previous endotracheal aspirate allows guiding the initial treatment of ventilator-associated pneumonia.
Article in Intensive care medicine, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Strategies to reduce curative antibiotic therapy in intensive care units (adult and paediatric).Intensive care medicine · 2015Guideline
- Value of lower respiratory tract surveillance cultures to predict bacterial pathogens in ventilator-associated pneumonia: systematic review and diagnostic test accuracy meta-analysis.Intensive care medicine · 2013Pooled it
- Outcomes and time trends of acute respiratory distress syndrome patients with and without liver cirrhosis: an observational cohort.Annals of intensive care · 2023Article
- Are tracheal surveillance cultures useful in the intensive care unit?Annals of translational medicine · 2018Review
- Pseudomonas aeruginosa colonization enhances ventilator-associated pneumonia-induced lung injury.Respiratory research · 2016Article
- Minimizing antibiotic exposure in the ICU: in search of the optimal strategy.Critical care (London, England) · 2014Article
- Development of antibiotic treatment algorithms based on local ecology and respiratory surveillance cultures to restrict the use of broad-spectrum antimicrobial drugs in the treatment of hospital-acquired pneumonia in the intensive care unit: a retrospective analysis.Critical care (London, England) · 2014Article
- Implications of endotracheal tube biofilm in ventilator-associated pneumonia response: a state of concept.Critical care (London, England) · 2012Observational
- Microbiogical data, but not procalcitonin improve the accuracy of the clinical pulmonary infection score.Intensive care medicine · 2010Article
- [Hot topics respiratory infections].Archivos de bronconeumologia · 2010Review
- Year in review in Intensive Care Medicine 2009: I. Pneumonia and infections, sepsis, outcome, acute renal failure and acid base, nutrition and glycaemic control.Intensive care medicine · 2010Review
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesAny delay in adequate antibiotic treatment compromises the outcome of ventilator-associated pneumonia (VAP). However, the diagnosis and optimal treatment of VAP remain a challenge for intensivists. We assessed the potential impact of using results of routine weekly endotracheal aspirate (EA) cultures to guide initial antibiotic treatment for VAP. DESIGN AND
settingRetrospective analysis of prospectively collected data in a medical-surgical intensive care unit (ICU) of a university hospital. PATIENTS AND
methodsWe studied 113 VAP episodes and evaluated the concordance between the latest EA and the broncho-alveolar lavage (BAL). We stratified patients into three groups: concordant EA-BAL (concordant group), discordant EA-BAL (discordant group) and EA not performed group. We then compared the adequacy of the antibiotic prescribed initially and outcomes between the three groups. MEASUREMENTS AND MAIN
resultsNinety assessable EA-BAL samples were evaluated. When guided by EA, the initial antibiotic regimen was adequate in 85% of situations, a proportion significantly superior (P < 0.05) to that resulting from application of the ATS guidelines (73%). When clinicians did not have a pre-VAP EA to guide their treatment (EA not performed group), only 61% of treatments were adequate. No significant difference was observed between the three groups for length of mechanical ventilation, length of ICU stay, nonpulmonary nosocomial infections and mortality.
conclusionOnce-a-week routine quantitative EA cultures may help to improve the adequacy of empiric antibiotic therapy for VAP.
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