دورية أكاديمية
Early-onset ventilator-associated pneumonia in adults randomized clinical trial: comparison of 8 versus 15 days of antibiotic treatment
| العنوان: | Early-onset ventilator-associated pneumonia in adults randomized clinical trial: comparison of 8 versus 15 days of antibiotic treatment |
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| المؤلفون: | Capellier, Gilles, Mockly, Hélène, Charpentier, Claire, Annane, Djillali, Blasco, Gilles, Desmettre, Thibault, Roch, Antoine, Faisy, Christophe, Cousson, Joel, Limat, Samuel, Mercier, Mariette, Papazian, Laurent |
| المساهمون: | CIT-IT Garches, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré AP-HP -Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Raymond Poincaré AP-HP, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Laboratoire Chrono-environnement (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté COMUE (UBFC)-Université Bourgogne Franche-Comté COMUE (UBFC), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques - CNRS Biologie (INSB-CNRS)-Institut des sciences biologiques - CNRS Biologie (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Service de Réanimation des Détresses Respiratoires et Infections Sévères, Assistance Publique - Hôpitaux de Marseille (APHM), Service de soins intensifs, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou APHP (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC) |
| المصدر: | ISSN: 1932-6203. |
| بيانات النشر: | HAL CCSD Public Library of Science |
| سنة النشر: | 2012 |
| مصطلحات موضوعية: | Antibiotics, Pneumonia, Bacterial pathogens, Death rates, Intensive care units, Respiratory infections, Enterococcus infections, Intubation, MESH: Adult, MESH: Aged, MESH: Female, MESH: Humans, MESH: Intensive Care, MESH: Intensive Care Units, MESH: Intubation, MESH: Male, MESH: Middle Aged, MESH: Odds Ratio, MESH: Pneumonia, Ventilator-Associated, MESH: Prospective Studies, MESH: Time Factors, MESH: Treatment Outcome, MESH: Anti-Bacterial Agents, MESH: Bronchoalveolar Lavage, MESH: Cohort Studies, MESH: Cross Infection, MESH: Drug Administration Schedule, MESH: Drug Resistance, Bacterial |
| الوصف: | International audience ; PurposeThe optimal treatment duration for ventilator-associated pneumonia is based on one study dealing with late-onset of the condition. Shortening the length of antibiotic treatment remains a major prevention factor for the emergence of multiresistant bacteria.ObjectiveTo demonstrate that 2 different antibiotic treatment durations (8 versus 15 days) are equivalent in terms of clinical cure for early-onset ventilator-associated pneumonia.MethodsRandomized, prospective, open, multicenter trial carried out from 1998 to 2002.MeasurementsThe primary endpoint was the clinical cure rate at day 21. The mortality rate was evaluated on days 21 and 90.Results225 patients were included in 13 centers. 191 (84.9%) patients were cured: 92 out of 109 (84.4%) in the 15 day cohort and 99 out of 116 (85.3%) in the 8 day cohort (difference = 0.9%, odds ratio = 0.929). 95% two-sided confidence intervals for difference and odds ratio were [−8.4% to 10.3%] and [0.448 to 1.928] respectively. Taking into account the limits of equivalence (10% for difference and 2.25 for odds ratio), the objective of demonstrative equivalence between the 2 treatment durations was fulfilled. Although the rate of secondary infection was greater in the 8 day than the 15 day cohort, the number of days of antibiotic treatment remained lower in the 8 day cohort. There was no difference in mortality rate between the 2 groups on days 21 and 90.ConclusionOur results suggest that an 8-day course of antibiotic therapy is safe for early-onset ventilator-associated pneumonia in intubated patients. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/22952580; hal-00825706; https://hal.science/hal-00825706Test; https://hal.science/hal-00825706/documentTest; https://hal.science/hal-00825706/file/journal.pone.0041290.PDFTest; PUBMED: 22952580 |
| DOI: | 10.1371/journal.pone.0041290 |
| الإتاحة: | https://doi.org/10.1371/journal.pone.0041290Test https://hal.science/hal-00825706Test https://hal.science/hal-00825706/documentTest https://hal.science/hal-00825706/file/journal.pone.0041290.PDFTest |
| حقوق: | http://creativecommons.org/licenses/byTest/ ; info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: | edsbas.5E449F1E |
| قاعدة البيانات: | BASE |
| DOI: | 10.1371/journal.pone.0041290 |
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