SynthesisBMJ (Clinical research ed.)1998
Effectiveness of antibiotic prophylaxis in critically ill adult patients: systematic review of randomised controlled trials.
Synthesis in BMJ (Clinical research ed.), 1998. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 9 of them syntheses that pooled 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.
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.
Who cites it
61 citing papers in PubMed, 9 syntheses or guidelines pooled it, 454 citations in OpenAlex.
- Effectiveness of antibiotic prophylaxis for ventilator-associated pneumonia in acute brain injury: a systematic review and meta-analysis.Infection · 2026Pooled it
- Effectiveness of antibiotic prophylaxis in polytrauma patients: a systematic review and meta-analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Pooled it
- Topical antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving mechanical ventilation.The Cochrane database of systematic reviews · 2021Pooled it
- Antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving intensive care.The Cochrane database of systematic reviews · 2009Pooled it
- The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration.BMJ (Clinical research ed.) · 2009Guideline
- The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration.PLoS medicine · 2009Guideline
- Guidelines for the management of hospital-acquired pneumonia in the UK: report of the working party on hospital-acquired pneumonia of the British Society for Antimicrobial Chemotherapy.The Journal of antimicrobial chemotherapy · 2008Guideline
- Oral decontamination for prevention of pneumonia in mechanically ventilated adults: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2007Pooled it
- Ventilator-associated pneumonia: diagnosis, treatment, and prevention.Clinical microbiology reviews · 2006Guideline
- Trial
- Preoperative synbiotic bowel conditioning for elective colorectal surgery.Wiener klinische Wochenschrift · 2010Trial
- Use of the probiotic Lactobacillus plantarum 299 to reduce pathogenic bacteria in the oropharynx of intubated patients: a randomised controlled open pilot study.Critical care (London, England) · 2008Trial
- The effect of selective decontamination of the digestive tract on mortality in multiple trauma patients: a multicenter randomized controlled trial.Intensive care medicine · 2007Trial
- Cost effectiveness of selective decontamination of the digestive tract in liver transplant patients.PharmacoEconomics · 2001Trial
- Are arms-based methods required to test the stable unit treatment value assumption (SUTVA) among Cochrane reviews of contagious infection prevention interventions?Global epidemiology · 2026Article
- Testing the Stable Unit Treatment Variance Assumption (SUTVA) Within Cochrane Reviews of Antimicrobial-Based Pneumonia Prevention Interventions Among Mechanically Ventilated Patients Using Caterpillar Plots.Journal of clinical medicine · 2025Article
- [Update of the recommendations of the Pneumonia Zero project].Enfermeria intensiva · 2022Review
- Selective digestive decontamination, a seemingly effective regimen with individual benefit or a flawed concept with population harm?Critical care (London, England) · 2021Article
- The Intestinal Microbiome in Infectious Diseases: The Clinical Relevance of a Rapidly Emerging Field.Open forum infectious diseases · 2017Review
- Pneumonia in Trauma Patients.Current trauma reports · 2017Review
1 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine whether antibiotic prophylaxis reduces respiratory tract infections and overall mortality in unselected critically ill adult patients.
designMeta-analysis of randomised controlled trials from 1984 and 1996 that compared different forms of antibiotic prophylaxis used to reduce respiratory tract infections and mortality with aggregate data and, in a subset of trials, data from individual patients. SUBJECTS: Unselected critically ill adult patients; 5727 patients for aggregate data meta-analysis, 4343 for confirmatory meta-analysis with data from individual patients.
main outcome measuresRespiratory tract infections and total mortality.
resultsTwo categories of eligible trials were defined: topical plus systemic antibiotics versus no treatment and topical preparation with or without a systemic antibiotic versus a systemic agent or placebo. Estimates from aggregate data meta-analysis of 16 trials (3361 patients) that tested combined treatment indicated a strong significant reduction in infection (odds ratio 0.35; 95% confidence interval 0.29 to 0.41) and total mortality (0.80; 0.69 to 0.93). With this treatment five and 23 patients would need to be treated to prevent one infection and one death, respectively. Similar analysis of 17 trials (2366 patients) that tested only topical antibiotics indicated a clear reduction in infection (0.56; 0.46 to 0.68) without a significant effect on total mortality (1.01; 0.84 to 1.22). Analysis of data from individual patients yielded similar results. No significant differences in treatment effect by major subgroups of patients emerged from the analyses.
conclusionsThis meta-analysis of 15 years of clinical research suggests that antibiotic prophylaxis with a combination of topical and systemic drugs can reduce respiratory tract infections and overall mortality in critically ill patients. This effect is significant and worth while, and it should be considered when practice guidelines are defined.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.