Neuroanesthesia & neurocritical care
Associations Between Prophylactic IV Antibiotics and Outcomes in Patients With Acute Severe Brain Injury Who Require Mechanical Ventilation: Systematic Review and Meta-Analysis
Pooled result · VAPResult — go to the resultRelative risk 0.61 95% CI 0.47–0.78Authors' conclusion
Among critically ill patients with acute brain injury, prophylactic IV antibiotics were associated with less VAP but not with changes in length of stay, mortality, or neurologic outcomes.
Study context
- Population
- Mechanically ventilated patients aged 16 years or older with severe acute brain injury (e.g., trauma, stroke, hypoxia)
- Participants
- 827 participants · 7 RCTs
- Comparison
- Prophylactic IV antibiotics vs placebo or no antibiotics
- Outcome
- VAP
Methodological detailsinverse-variance random-effects models, Cochrane risk-of-bias assessment, sensitivity analyses
- Inverse-variance random-effects models
- Cochrane risk-of-bias assessment
- Sensitivity analyses
Pooled result
As reported in the abstract
Relative risk
0.61
95% CI 0.47–0.78
Prophylactic antibiotics vs Placebo or no antibiotics
RR 0.61 (95% CI 0.47–0.78)
Further pooled results
| Outcome | MD (95% CI) | |
|---|---|---|
| Duration of mechanical ventilation | −0.45 (−1.63 to +0.74) | |
| −2−101Difference (linear scale) |
| Outcome | MD (d) (95% CI) | |
|---|---|---|
| ICU LOS | −1.76 (−3.94 to +0.42) | |
| −4−202Difference, d (linear scale) |
| Outcome | RR (95% CI) | |
|---|---|---|
| Hospital mortality | 0.91 (0.74–1.12) | |
| 0.512Relative risk (log scale) |
Long-term neurologic outcomes
- Not associated with changes in long-term neurologic outcomes
Mechanism of injury: structural vs hypoxic brain injury (subgroup)
- Significantly less ventilator-associated pneumonia (VAP), shorter ICU LOS and a trend toward lower mortality with prophylaxis in structural but not hypoxic brain injuries
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Associations Between Prophylactic IV Antibiotics and Outcomes in Patients With Acute Severe Brain Injury Who Require Mechanical Ventilation: Systematic Review and Meta-Analysis. Crit Care Med. Published 28 March 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →