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Annals of Intensive Care

Table 1 Studies’ characteristics

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

  Sirvent JM et al. Acquarolo A et al. Vallés J et al.
Year published 1997 2007 2013
Country Spain Italy Spain
Study design RCT RCT Prospective study with historical control or non-randomized control
Inclusion criteria Head injury or coma due to stroke or surgery for space occupying lesions with Glasgow ≤ 12 Adults, comatose patients (GCS ≤ 8) in mechanical ventilation Adults, comatose patients (GCS ≤ 8) in mechanical ventilation
Tested antibiotic Cefuroxime Ampicillin–sulbactam Ceftriaxone or ertapenem or levofloxacin
Antibiotics used in control group?b Yes Yes No
  Intervention group Control group Intervention group Control group Intervention group Control group
Number of subjects 50 50 19 19 71 58
Age (mean ± SD), years 42 ± 20 37 ± 21 54.8 (18.0)a 54.6 (17.7)a 56 ± 19 59 ± 16
Male gender, n (%) 34 (68%) 40 (80%) 13 (68.4%) 12 (63.2%) 48 (67.6%) 43 (74.1%)
Glasgow Coma Scale (mean ± SD) 7.5 ± 2.4 8.0 ± 1.8 5 (3–7)a 5 (4–7)a 5 ± 2 5 ± 2
APACHE II (mean ± SD) 14 ± 5 13 ± 5 20 (17–24)a 22 (18–23)a 17 ± 7 18 ± 7
Early VAP, n (%) 8 (16%) 18 (36%) 4 (21%) 11 (57.8%) 2 (2.8%) 13 (22.4%)
Late VAP, n (%) 4 (8%) 7 (14%) 10 (episodes) 9 (episodes) 6.5 (incidence/1000 days MV) 5.3 (incidence/1000 days MV)
Total VAP, n (%) 12 (24%) 25 (50%) 14 (episodes) 20 (episodes) 10.8 (incidence/1000 days MV) 28.4 (incidence/1000 days MV)
Duration of mechanical ventilation (mean ± SD), days 4.6 ± 1.5 4.4 ± 2.1 9.9 (6.9)a 10.6 (9.4)a 6.4 ± 6.5 9.7 ± 9.6
ICU LOS (mean ± SD), days 13 ± 8 16 ± 11 12.8 (8.7)a 12.6 (9.7)a 9.7 ± 9.8 14.9 ± 13.9
Hospital LOS (mean ± SD), days 27 ± 16 28 ± 13 Not informed Not informed 17.5 ± 17.7 23.5 ± 24.3
ICU mortality, n (%) 10 (20%) 7 (14%) 7 (36.8%) 8 (42.1%) 21 (29.6%) 18 (31%)
  1. RCT randomized controlled trial, VAP ventilator-associated pneumonia, LOS length of stay, APACHE II Acute Physiology and Chronic Health Evaluation II, MV mechanical ventilation
  2. aMedian (interquartile range)
  3. bAntibiotics used mainly as surgical prophylaxis
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