Trial reportCritical care (London, England)2023
Association between combination antibiotic therapy as opposed as monotherapy and outcomes of ICU patients with Pseudomonas aeruginosa ventilator-associated pneumonia: an ancillary study of the iDIAPASON trial.
Trial report in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02634411 (Impact of the Duration of Antibiotics on Clinical Events in Patients With Pseudomonas Aeruginosa Ventilator-associated Pneumonia), which is not on this map. Cited by 16 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Impact of the Duration of Antibiotics on Clinical Events in Patients With Pseudomonas Aeruginosa Ventilator-associated Pneumonia : a Randomized Controlled Study (iDIAPASON)
Who cites it
16 citing papers in PubMed, 22 citations in OpenAlex.
- Antimicrobial Resistance and Virulence ofAntibiotics (Basel, Switzerland) · 2026Article
- Systematic Review of Antimicrobial Therapies and Clinical Outcomes inLife (Basel, Switzerland) · 2026Review
- Is less always more? Ceftazidime/avibactam alone or in combination to treat infections caused by Pseudomonas aeruginosa: a retrospective observational multi-centre cohort study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Phenotypic convergence and collateral susceptibility development in Pseudomonas aeruginosa under antibiotic exposure in ICU patients.npj antimicrobials and resistance · 2026Article
- Phenotypic and Whole-Genome Sequencing-Based Profiling of Antimicrobial Resistance and Virulence inGenes · 2026Article
- Clinical Outcomes and Predictors of Mortality in Patients with Difficult-to-Treat ResistantAntibiotics (Basel, Switzerland) · 2026Article
- Risk Factors, Pathogen Distribution, and Treatment Strategies for Mortality in Elderly Patients with Pulmonary Bacterial Infections.Clinical interventions in aging · 2026Article
- Risk factors for 30-Day mortality and the role of empirical therapy in Pseudomonas aeruginosa bloodstream infections.Infection · 2025Article
- Development and evaluation of new nanoformulated thiolactone derivatives for enhanced disruption of pseudomonal biofilms.RSC advances · 2025Article
- Combating Metallo-β-Lactamase-ProducingAntibiotics (Basel, Switzerland) · 2025Article
- Mechanical Ventilator-Associated Pneumonia in the COVID-19 Pandemic Era: A Critical Challenge in the Intensive Care Units.Antibiotics (Basel, Switzerland) · 2025Article
- Development and Validation of a Nomogram for Predicting Multidrug-ResistantInfection and drug resistance · 2025Article
- Effect of ICU Quality Control and Secondary Analysis: A 12-Year Multicenter Quality Improvement Project.Journal of multidisciplinary healthcare · 2025Article
- Single-drug versus combination antimicrobial therapy in critically ill patients with hospital-acquired pneumonia and ventilator-associated pneumonia due to Gram-negative pathogens: a multicenter retrospective cohort study.Critical care (London, England) · 2024Article
- Antimicrobial resistance ofFrontiers in microbiology · 2024Review
- Monotherapy or combination antibiotic therapy in the treatment of Pseudomonas aeruginosa ventilator-associated pneumonia.Critical care (London, England) · 2023Article
Corrections and comments
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Authors and funding
17 authors at 9 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe optimal treatment duration and the nature of regimen of antibiotics (monotherapy or combination therapy) for Pseudomonas aeruginosa ventilator‑associated pneumonia (PA-VAP) remain debated. The aim of this study was to evaluate whether a combination antibiotic therapy is superior to a monotherapy in patients with PA-VAP in terms of reduction in recurrence and death, based on the 186 patients included in the iDIAPASON trial, a multicenter, randomized controlled trial comparing 8 versus 15 days of antibiotic therapy for PA-VAP.
methodsPatients with PA-VAP randomized in the iDIAPASON trial (short-duration-8 days vs. long-duration-15 days) and who received appropriate antibiotic therapy were eligible in the present study. The main objective is to compare mortality at day 90 according to the antibiotic therapy received by the patient: monotherapy versus combination therapy. The primary outcome was the mortality rate at day 90. The primary outcome was compared between groups using a Chi-square test. Time from appropriate antibiotic therapy to death in ICU or to censure at day 90 was represented using Kaplan-Meier survival curves and compared between groups using a Log-rank test.
resultsA total of 169 patients were included in the analysis. The median duration of appropriate antibiotic therapy was 14 days. At day 90, among 37 patients (21.9%) who died, 17 received monotherapy and 20 received a combination therapy (P = 0.180). Monotherapy and combination antibiotic therapy were similar for the recurrence rate of VAP, the number of extra pulmonary infections, or the acquisition of multidrug-resistant (MDR) bacteria during the ICU stay. Patients in combination therapy were exposed to mechanical ventilation for 28 ± 12 days, as compared with 23 ± 11 days for those receiving monotherapy (P = 0.0243). Results remain similar after adjustment for randomization arm of iDIAPASON trial and SOFA score at ICU admission.
conclusionsExcept longer durations of antibiotic therapy and mechanical ventilation, potentially related to increased difficulty in achieving clinical cure, the patients in the combination therapy group had similar outcomes to those in the monotherapy group.
trial registrationNCT02634411 , Registered 15 December 2015.
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