Journal Article

Sedation, Sucralfate, and Antibiotic Use Are Potential Means for Protection against Early-Onset Ventilator-Associated Pneumonia

C. Bornstain, E. Azoulay, A. De Lassence, Y. Cohen, M. A. Costa, B. Mourvillier, A. Descorps-Declere, M. Garrouste-Orgeas, M. Thuong, B. Schlemmer and J.-F. Timsit

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 38, issue 10, pages 1401-1408
Published in print May 2004 | ISSN: 1058-4838
Published online May 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/386321
Sedation, Sucralfate, and Antibiotic Use Are Potential Means for Protection against Early-Onset Ventilator-Associated Pneumonia

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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), β-lactams and/or β-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, β-lactams/β-lactamase inhibitors, or third-generation cephalosporins protects against EOP.

Journal Article.  4080 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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