Evidence map›Paper›PMID 41379388›Full record

SynthesisInfection2026

Effectiveness of antibiotic prophylaxis for ventilator-associated pneumonia in acute brain injury: a systematic review and meta-analysis.

Marcelo Costa, Aurelia Incristi, Justin Lindsay, Filipe Virgilio Ribeiro, Kristen Paradine, Tate Barney, Rahul Manne, Gustavo de Oliveira Almeida, Amelia Liu, Raphael Bertani and 1 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Marcelo CostaWright State University Boonshoft School of Medicine, Fairborn, OH, USA. costa.10@wright.edu.
Aurelia IncristiWright State University Boonshoft School of Medicine, Fairborn, OH, USA.
Justin LindsayWright State University Boonshoft School of Medicine, Fairborn, OH, USA.
Filipe Virgilio RibeiroCollege of Medicine, Barão de Mauá University Center, Ribeirão Preto, SP, Brazil.
Kristen ParadineWright State University Boonshoft School of Medicine, Fairborn, OH, USA.
Tate BarneyWright State University Boonshoft School of Medicine, Fairborn, OH, USA.
Rahul ManneWright State University Boonshoft School of Medicine, Fairborn, OH, USA.
Gustavo de Oliveira AlmeidaDepartment of Neurosurgery, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil.
Amelia LiuWright State University Boonshoft School of Medicine, Fairborn, OH, USA.
Raphael BertaniDepartment of Neurosurgery, University of São Paulo, São Paulo, SP, Brazil.
Wellingson Silva PaivaDepartment of Neurosurgery, University of São Paulo, São Paulo, SP, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVentilator-associated pneumonia (VAP) affects 30-50% of mechanically ventilated patients with acute brain injury (ABI), exceeding general ICU rates (10-20%) due to aspiration risks and immunosuppression, prolonging ICU stays and morbidity. Although short-course antibiotic prophylaxis (AP; e.g., ceftriaxone) targets early VAP, efficacy in ABI remains debated amid mixed evidence, resistance concerns, and non-endorsement by IDSA/ATS guidelines.

methodsWe searched PubMed, Cochrane Library, and Web of Science (inception to October 2024) for RCTs and non-RCTs on systemic AP (short-course beta-lactams) for VAP prevention in ABI (TBI, SAH, stroke, post-arrest coma) requiring ventilation ≥ 48 h. PRIMARY OUTCOMES: early-onset VAP (≤ 96 h), late-onset VAP (> 96 h), overall VAP, ICU mortality. Secondaries: mechanical ventilation duration, ICU/hospital length of stay (LOS), time to first VAP. Random-effects meta-analysis; heterogeneity via I

resultsTen studies (5 RCTs [n = 586], 5 non-RCTs [n = 1,087]; total n = 1,673) were included. AP reduced overall VAP (RR = 0.65, 95% CI: 0.48-0.90, P < 0.001; I

conclusionShort-course AP reduces early/overall VAP and LOS in ABI without impacting late VAP or mortality, supporting targeted use in high-risk cases (e.g., GCS < 8) per stewardship principles. However, heterogeneity, resistance gaps, and guideline caution warrant larger RCTs with non-ABI comparatives to mitigate selection bias and confirm specificity.

Indexed as

Anti-Bacterial AgentsAntibiotic ProphylaxisBrain InjuriesPneumonia, Ventilator-AssociatedHumansIntensive Care UnitsLength of StayRespiration, ArtificialTreatment OutcomeAnti-Bacterial AgentsAcute brain injuryAntibiotic prophylaxisICU outcomesMechanical ventilationNeurocritical careVentilator-associated pneumonia

Identifiers

PMID41379388

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.