Antibiotic definitive treatment in ventilator associated pneumonia caused by AmpC-producing Enterobacterales in critically ill patients: a prospective multicenter observational study
Authors' conclusion
Choice of definitive antimicrobial therapy was not associated with treatment success at day 7. However, recurrence of pneumonia at day-28 was higher in patients treated with third generation cephalosporins with no differences in mortality or mechanical ventilation duration.
Study context
- Population
- Intensive care unit (ICU) patients with ventilator associated pneumonia (VAP) due to wild-type AmpC-producing Enterobacterales, 20 French ICUs
- Participants
- 274 patients
- Exposure
- Definitive antimicrobial therapy (AMT) with piperacillin ± tazobactam (PTZ) or 3GCs vs other molecule
- PTZn = 78
- 3GCsn = 44
- Controln = 152reference
- Outcome
- Treatment success
- Follow-up
- Day 7
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
P = 0.814
Observational data: associations, not effects.
Secondary outcomes
| Outcome | csHR (95% CI) | |
|---|---|---|
| Recurrence probability (competing risk of death) · day 283GCs vs Control · multivariable analysis | 10.9 (1.92–61.91) | |
| 0.050.21520Cause-specific hazard ratio (log scale) |
| Outcome | PTZ | 3GCs | Control | P value |
|---|---|---|---|---|
| Recurrence probability (competing risk of death) · day 28PTZ vs 3GCs vs Control vs Control | 31% (95% CI 21–42) | 40% (95% CI 26–55) | 21% (95% CI 15–28) | P = 0.020 |
Mortality and mechanical ventilation duration
- No differences in mortality or mechanical ventilation duration
Original publication
Antibiotic definitive treatment in ventilator associated pneumonia caused by AmpC-producing Enterobacterales in critically ill patients: a prospective multicenter observational study. Crit Care. Published 5 February 2024. doi:10.
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