| Author | Righy, Cássia | |
| Author | Brasil, Pedro Emmanuel Americano do | |
| Author | Vallés, Jordi | |
| Author | Bozza, Fernando A. | |
| Author | Martin-Loeches, Ignacio | |
| Access date | 2019-08-07T14:06:05Z | |
| Available date | 2019-08-07T14:06:05Z | |
| Document date | 2017 | |
| Citation | RIGHY, Cássia et al. Systemic antibiotics for preventing ventilator-associated pneumonia in comatose patients: a systematic review and meta-analysis. Annals of Intensive Care, v. 7, p. 1-8, 2017. | pt_BR |
| ISSN | 2110-5820 | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/34650 | |
| Language | eng | pt_BR |
| Publisher | BMC | pt_BR |
| Rights | open access | pt_BR |
| Title | Systemic antibiotics for preventing ventilator-associated pneumonia in comatose patients: a systematic review and meta-analysis | pt_BR |
| Type | Article | pt_BR |
| DOI | 10.1186/s13613-017-0291-4 | |
| Abstract | Background: Early-onset ventilator-associated pneumonia (EO-VAP) is the leading cause of morbidity and mortality in comatose patients. However, VAP prevention bundles focus mainly on late-onset VAP and may be less efective in preventing EO-VAP in comatose patients. Systemic antibiotic administration at the time of intubation may have a role in preventing EO-VAP. Therefore, we evaluated the efectiveness of systemic antibiotic administration in VAP prevention in comatose patients through a systematic review and meta-analysis. Methods: We searched for studies published through December 2015 that evaluated systemic antibiotic prophylaxis in comatose patients. Two authors independently selected and evaluated full-length reports of randomized clinical trials or prospective cohorts in patients aged >16 years that evaluated the impact of systemic antibiotics at the time of intubation on EO-VAP compared to placebo or no prophylaxis. The outcome variables were the incidence of EOVAP, the duration of mechanical ventilation, ICU length of stay, and ICU mortality. Results: We identifed 10,988 citations, yielding 26 articles for further analysis; three studies with 267 patients were fnally analyzed. Most patients (n = 135) were comatose due to head trauma. Systemic antibiotic administration was associated with decreased incidence of EO-VAP (RR 0.32; 95% CI 0.19–0.54) and shorter ICU LOS (standardized mean diference −0.32; 95% CI −0.56 to −0.08), but had no efect on mortality (RR 1.03; 95% CI 0.7–1.53) or duration of mechanical ventilation (standardized mean diference −0.16; 95% CI −0.41 to 0.08). Conclusions: Antibiotic prophylaxis in comatose patients reduced the incidence of EO-VAP and decreased the ICU stay slightly. Future trials are needed to confrm these results. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Paulo Niemeyer Brain Institute. ICU. Rio de Janeiro, RJ, Brazil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | CIBER Enfermedades Respiratorias. Barcelona, Spain / CIBER Enfermedades Respiratorias. Hospital Sabadell. Critical Care Center. Sabadell, Spain. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / D’Or Institute for Research and Education. Rio de Janeiro, Brazil. | pt_BR |
| Affilliation | CIBER Enfermedades Respiratorias. Barcelona, Spain / Trinity Centre for Health Sciences. Multidisciplinary Intensive Care Research Organization. Department of Clinical Medicine / HRB Clinical Research. Wellcome Trust. Dublin, Ireland / St. James’s University Hospital Dublin. Dublin, Ireland / Irish Centre for Vascular Biology. Dublin, Ireland. | pt_BR |
| Subject | Systematic review | pt_BR |
| Subject | Meta-analysis | pt_BR |
| Subject | Ventilator-associated pneumonia | pt_BR |
| Subject | Coma | pt_BR |
| e-ISSN | 2110-5820 | |
