Immediate vs. culture-initiated antibiotic therapy in suspected non-severe ventilator-associated pneumonia: a before–after study (DELAVAP)
Authors' conclusion
In patients with suspected non-severe VAP, waiting for microbiological confirmation was not associated with antibiotic sparing, compared to immediate AT.
Study context
- Population
- Patients undergoing distal respiratory sampling for a first suspected non-severe ventilator-associated pneumonia (VAP) episode (no shock requiring vasopressors or severe ARDS)
- Participants
- 43 vs 44
- Comparison
- Conservative vs immediate antibiotic therapy after sampling
- Conservativen = 43
- Immediaten = 44reference
- Outcome
- Days alive without antibiotic therapy
- Follow-up
- Day 28
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Main finding
As reported in the abstract
P = 0.50
Secondary outcomes
AT suitability (active necessary AT or spared AT) · more often suitable with conservative strategy
P = 0.01
| Outcome | P value |
|---|---|
| Days alive without broad-spectrum AT · day 28Similar | P = 0.53 |
- Antibiotic therapy (AT) suitability (active necessary AT or spared AT) — Conservative patients receiving no AT at all
- 27.9%
MV duration
- No significant difference between strategies; median [95%CI], days
- 9.0 [6-19] vs. 9.0 [6-24] days, p = 0.65
Day-28 mortality
- No significant difference between strategies; HR [95%CI]
- 0.85 [0.4-2.0], p = 0.71
Original publication
Immediate vs. culture-initiated antibiotic therapy in suspected non-severe ventilator-associated pneumonia: a before–after study (DELAVAP). Ann Intensive Care. Published 27 February 2024. doi:10.
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