Systemic antibiotics for preventing ventilator-associated pneumonia in comatose patients: a systematic review and meta-analysis

Detalhes bibliográficos
Autor(a) principal: Righy, Cássia
Data de Publicação: 2017
Outros Autores: Brasil, Pedro Emmanuel Americano do, Vallés, Jordi, Bozza, Fernando A., Martin-Loeches, Ignacio
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/34650
Resumo: Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Paulo Niemeyer Brain Institute. ICU. Rio de Janeiro, RJ, Brazil.
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spelling Righy, CássiaBrasil, Pedro Emmanuel Americano doVallés, JordiBozza, Fernando A.Martin-Loeches, Ignacio2019-08-07T14:06:05Z2019-08-07T14:06:05Z2017RIGHY, Cássia et al. Systemic antibiotics for preventing ventilator-associated pneumonia in comatose patients: a systematic review and meta-analysis. Annals of Intensive Care, v. 7, p. 1-8, 2017.2110-5820https://www.arca.fiocruz.br/handle/icict/3465010.1186/s13613-017-0291-42110-5820engBMCSystemic antibiotics for preventing ventilator-associated pneumonia in comatose patients: a systematic review and meta-analysisinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Paulo Niemeyer Brain Institute. ICU. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.CIBER Enfermedades Respiratorias. Barcelona, Spain / CIBER Enfermedades Respiratorias. Hospital Sabadell. Critical Care Center. Sabadell, Spain.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / D’Or Institute for Research and Education. Rio de Janeiro, Brazil.CIBER Enfermedades Respiratorias. Barcelona, Spain / Trinity Centre for Health Sciences. Multidisciplinary Intensive Care Research Organization. Department of Clinical Medicine / HRB Clinical Research. Wellcome Trust. Dublin, Ireland / St. James’s University Hospital Dublin. Dublin, Ireland / Irish Centre for Vascular Biology. Dublin, Ireland.Background: Early-onset ventilator-associated pneumonia (EO-VAP) is the leading cause of morbidity and mortality in comatose patients. However, VAP prevention bundles focus mainly on late-onset VAP and may be less efective in preventing EO-VAP in comatose patients. Systemic antibiotic administration at the time of intubation may have a role in preventing EO-VAP. Therefore, we evaluated the efectiveness of systemic antibiotic administration in VAP prevention in comatose patients through a systematic review and meta-analysis. Methods: We searched for studies published through December 2015 that evaluated systemic antibiotic prophylaxis in comatose patients. Two authors independently selected and evaluated full-length reports of randomized clinical trials or prospective cohorts in patients aged >16 years that evaluated the impact of systemic antibiotics at the time of intubation on EO-VAP compared to placebo or no prophylaxis. The outcome variables were the incidence of EOVAP, the duration of mechanical ventilation, ICU length of stay, and ICU mortality. Results: We identifed 10,988 citations, yielding 26 articles for further analysis; three studies with 267 patients were fnally analyzed. Most patients (n = 135) were comatose due to head trauma. Systemic antibiotic administration was associated with decreased incidence of EO-VAP (RR 0.32; 95% CI 0.19–0.54) and shorter ICU LOS (standardized mean diference −0.32; 95% CI −0.56 to −0.08), but had no efect on mortality (RR 1.03; 95% CI 0.7–1.53) or duration of mechanical ventilation (standardized mean diference −0.16; 95% CI −0.41 to 0.08). Conclusions: Antibiotic prophylaxis in comatose patients reduced the incidence of EO-VAP and decreased the ICU stay slightly. Future trials are needed to confrm these results.Systematic reviewMeta-analysisVentilator-associated pneumoniaComainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txttext/plain1748https://www.arca.fiocruz.br/bitstream/icict/34650/1/license.txt8a4605be74aa9ea9d79846c1fba20a33MD51ORIGINALve_Righy_Cássia_etal_INI_2017.pdfve_Righy_Cássia_etal_INI_2017.pdfapplication/pdf1341558https://www.arca.fiocruz.br/bitstream/icict/34650/2/ve_Righy_C%c3%a1ssia_etal_INI_2017.pdf416ca84d03ad9724f3360aa1dddc48b9MD52TEXTve_Righy_Cássia_etal_INI_2017.pdf.txtve_Righy_Cássia_etal_INI_2017.pdf.txtExtracted texttext/plain34828https://www.arca.fiocruz.br/bitstream/icict/34650/3/ve_Righy_C%c3%a1ssia_etal_INI_2017.pdf.txta0aa2e6cb2edbb6937491f557f6a4657MD53icict/346502019-08-08 02:03:31.207oai:www.arca.fiocruz.br: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Repositório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352019-08-08T05:03:31Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false
dc.title.pt_BR.fl_str_mv Systemic antibiotics for preventing ventilator-associated pneumonia in comatose patients: a systematic review and meta-analysis
title Systemic antibiotics for preventing ventilator-associated pneumonia in comatose patients: a systematic review and meta-analysis
spellingShingle Systemic antibiotics for preventing ventilator-associated pneumonia in comatose patients: a systematic review and meta-analysis
Righy, Cássia
Systematic review
Meta-analysis
Ventilator-associated pneumonia
Coma
title_short Systemic antibiotics for preventing ventilator-associated pneumonia in comatose patients: a systematic review and meta-analysis
title_full Systemic antibiotics for preventing ventilator-associated pneumonia in comatose patients: a systematic review and meta-analysis
title_fullStr Systemic antibiotics for preventing ventilator-associated pneumonia in comatose patients: a systematic review and meta-analysis
title_full_unstemmed Systemic antibiotics for preventing ventilator-associated pneumonia in comatose patients: a systematic review and meta-analysis
title_sort Systemic antibiotics for preventing ventilator-associated pneumonia in comatose patients: a systematic review and meta-analysis
author Righy, Cássia
author_facet Righy, Cássia
Brasil, Pedro Emmanuel Americano do
Vallés, Jordi
Bozza, Fernando A.
Martin-Loeches, Ignacio
author_role author
author2 Brasil, Pedro Emmanuel Americano do
Vallés, Jordi
Bozza, Fernando A.
Martin-Loeches, Ignacio
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Righy, Cássia
Brasil, Pedro Emmanuel Americano do
Vallés, Jordi
Bozza, Fernando A.
Martin-Loeches, Ignacio
dc.subject.en.pt_BR.fl_str_mv Systematic review
Meta-analysis
Ventilator-associated pneumonia
Coma
topic Systematic review
Meta-analysis
Ventilator-associated pneumonia
Coma
description Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Paulo Niemeyer Brain Institute. ICU. Rio de Janeiro, RJ, Brazil.
publishDate 2017
dc.date.issued.fl_str_mv 2017
dc.date.accessioned.fl_str_mv 2019-08-07T14:06:05Z
dc.date.available.fl_str_mv 2019-08-07T14:06:05Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv RIGHY, Cássia et al. Systemic antibiotics for preventing ventilator-associated pneumonia in comatose patients: a systematic review and meta-analysis. Annals of Intensive Care, v. 7, p. 1-8, 2017.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/34650
dc.identifier.issn.pt_BR.fl_str_mv 2110-5820
dc.identifier.doi.none.fl_str_mv 10.1186/s13613-017-0291-4
dc.identifier.eissn.none.fl_str_mv 2110-5820
identifier_str_mv RIGHY, Cássia et al. Systemic antibiotics for preventing ventilator-associated pneumonia in comatose patients: a systematic review and meta-analysis. Annals of Intensive Care, v. 7, p. 1-8, 2017.
2110-5820
10.1186/s13613-017-0291-4
url https://www.arca.fiocruz.br/handle/icict/34650
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BMC
publisher.none.fl_str_mv BMC
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
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