Sedation, sucralfate, and antibiotic use are potential means for protection against early-onset ventilator-associated pneumonia.

Abstract

To examine risk factors for early-onset ventilator-associated pneumonia (EOP) in patients requiring mechanical ventilation (MV), we performed a prospective cohort study that included 747 patients. Pneumonia was defined as a positive result for a protected quantitative distal sample. EOP was defined as pneumonia that occurred from day 3 to day 7 of MV. Eighty patients (10.7%) experienced EOP. Independent predictors of EOP were male sex (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.18-3.63), actual Glasgow Coma Scale value of 6-13 (OR, 1.95; 95% CI, 1.2-3.18), high Logistic Organ Dysfunction score at day 2 (OR, 1.12 per point; 95% CI, 1.02-1.23), unplanned extubation (OR, 3.19; 95% CI, 1.28-7.92), and sucralfate use (OR, 1.81; 95% CI, 1.01-3.26). Protection occurred with use of aminoglycosides (OR, 0.36; 95% CI, 0.17-0.76), beta -lactams and/or beta -lactamase inhibitors (OR, 0.47; 95% CI, 0.28-0.83), or third-generation cephalosporins (OR, 0.33; 95% CI, 0.16-0.74). Sucralfate use and unplanned extubation are independent risk factors for EOP. Use of aminoglycosides, beta-lactams/ beta-lactamase inhibitors, or third-generation cephalosporins protects against EOP.

• Authors: C Bornstain, E Azoulay, A De Lassence, Y Cohen, M A Costa, B Mourvillier, A Descorps-Declere, M Garrouste-Orgeas, M Thuong, B Schlemmer, J-F Timsit, Outcomerea Study Group
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 38 Issue 10 Pg. 1401-8 (May 15 2004) ISSN: 1537-6591 [Electronic] United States
• PMID: 15156478 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• Sucralfate

Topics

• Aged
• Anti-Bacterial Agents (therapeutic use)
• Cohort Studies
• Female
• Humans
• Male
• Middle Aged
• Pneumonia, Bacterial (epidemiology, etiology, microbiology, prevention & control)
• Prospective Studies
• Respiration, Artificial
• Risk Factors
• Sucralfate (therapeutic use)
• Time Factors
• Ventilators, Mechanical (adverse effects)