Prognostic Impact of Early Appropriate Antimicrobial Therapy in Critically Ill Patients With Nosocomial Pneumonia Due to Gram-Negative Pathogens: A Multicenter Cohort Study
Main finding · Day 28 all-cause mortalityResult — go to the resultAdjusted hazard ratio 0.87 95% CI 0.67–1.12Authors' conclusion
In this study, EAAT was not associated with a reduced day 28 mortality, a faster resolution of organ failure, a higher day 14 clinical cure rate, or a shorter time to MV weaning or ICU discharge in critically ill patients with HAP, vHAP, or VAP due to GNB.
Study context
- Population
- Critically ill patients with a first hospital-acquired pneumonia (HAP), ventilated HAP (vHAP) or ventilator-associated pneumonia (VAP) due to Gram-negative bacteria, 32 French ICUs (OutcomeRéa network)
- Participants
- 804 patients · 32 French ICUs
- Exposure
- Early appropriate antimicrobial therapy vs no early appropriate antimicrobial therapy (EAAT)
- EAATn = 495
- Outcome
- All-cause mortality
- Follow-up
- Day 28
Methodological detailsprospectively collected data, multicentre
- Prospectively collected data
- Multicentre
Main finding
Day 28 all-cause mortality
Adjusted hazard ratio
0.87
95% CI 0.67–1.12
EAAT vs No EAAT
aHR 0.87 (95% CI 0.67–1.12)
As reported in the abstract
- Day 28 mortality, overall
- 32.6%
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Estimate | |
|---|---|---|
| MV duration (extubation) | cause-specific HR for extubation 0.84 (95% CI 0.69–1.01) | |
| ICU stay (discharge alive) | cause-specific HR for discharge alive 0.85 (95% CI 0.72–1.00) | |
| 0.512Ratio (log scale) |
| Outcome | P value |
|---|---|
| Decrease in SOFA score valuesNot associated with faster decrease | P = 0.11 |
Clinical cure rate · day 14
- Overall clinical cure rate
- 43.7%
- EAAT not associated with a higher clinical cure rate
Original publication
Prognostic Impact of Early Appropriate Antimicrobial Therapy in Critically Ill Patients With Nosocomial Pneumonia Due to Gram-Negative Pathogens: A Multicenter Cohort Study. Crit Care Med. Published 26 February 2025. doi:10.
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