Delayed Antibiotic Therapy in Non-severe Ventilator Acquired Pneumonia (VAP)

Aggressive Versus Restrictive Initiation of Antimicrobial Treatment in Critically Ill Patients With Suspected Ventilator Acquired Pneumonia Without Severity : a Before and After Observational Study

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT05205525

Acronym

DELAVAP

Enrollment

Registered

2022-01-25

Start date

2022-01-06

Completion date

2023-01-28

Last updated

2023-03-08

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Antibiotic Therapy, Critical Care, Ventilator Associated Pneumonia

Brief summary

This retro-prospective monocentric observational study compare the impact of the implementation of a restrictive (delayed) versus aggressive (immediate) antibiotic strategy for Ventilator Acquired Pneumonia suspicion without severity symptoms.

Detailed description

Ventilator acquired pneumonia (VAP) is the leading cause of nosocomial infection in intensive care patients, and has been associated with increased antibiotic consumption, increased morbidity and mortality. VAP diagnosis is difficult due to subjective or non-specific criteria. Delaying antibiotic treatment for VAP suspicion without severity symptoms raises question since the probability of VAP diagnosis, as well as the risk of delaying treatment, is very uncertain. It may nonetheless limit the environmental impact of antibiotic use which is a public health concern. We compared antibiotic sparing and patient outcome, before and after the implementation of a restrictive (delayed) antibiotic strategy versus an aggressive (immediate) antibiotic strategy in VAP suspicion without severity symptoms.

Interventions

OTHERRestrictive antibiotic strategy

Implementation of a restrictive (delayed) antibiotic strategy in Ventilator Acquired Pneumonia suspicion without severity symptoms.

OTHERAggressive antibiotic strategy

Implementation of an aggressive (immediate) antibiotic strategy in Ventilator Acquired Pneumonia suspicion without severity symptoms.

Study design

Observational model

CASE_CONTROL

Time perspective

OTHER

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

* Under mechanical ventilation from more than 48 hours * Suspected for a ventilator acquired pneumonia, requiring a distal pulmonary bacterial sample

Exclusion criteria

* New or worsening shock requiring vasopressor * New or worsening severe hypoxemia (PaO2/FiO2\<150 in FiO2≥60% and peep 10) * Patient under veno-veinous extracorporeal membrane oxygenation * Neutropenia \<1G/L or immunosuppressive treatment (including corticosteroids \>6 months or \>0.5mg/kg/j) * Disease (endocarditis, spondylodyscitis, deep abcedation…) requiring prolonged antibiotic therapy

Design outcomes

Primary

Measure	Time frame	Description
antibiotic-free days	28 days	antibiotic-free days until Day 28 of Intensive Care Units stay

Secondary

Measure	Time frame	Description
Mechanical ventilation free days	28 days	Mechanical ventilation free days during the first 28 days
Intensive care unit stay length	28 days	—
Intensive care unit mortality	28 days	—
Hospitality mortality	28 days	—

Countries

France

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026