Ventilator Associated Pneumonia ventilator-
Conditions
Interventions
serum PCT level was first assessed after the enrolled patients received appropriate antibiotic for 7 days (day 8),
revealed favorable clinical response within 7 days of appropriate antibiotic treatment including: body temperature < 37.8°C
without shock or use of inotropes or vasopressors and Clinical pulmonary infection score < 6. In the PCT group,
If PCT was less than 0.5 ng/mL,
antibiotics had to be discontinued. If PCT was 0.5 ng/mL or more,
antibiotics were to be continue and PCT level was reassessed two days later. If PCT was less than 0.5 ng/mL,
antibiotics were discontinued. If PCT was 0.5 ng/mL or more,
antibiotics were continued for 14 days. ,In the conventional group,
serum PCT level was assessed once. However,
the treating physicians were not informed the result of this serum PCT and antibiotics discontinuation would be determined according to the treating physicians discretion.
Experimental Behavioral,No Intervention Behavioral
PCT group,Conventional group
Sponsors
-
-
,-
Eligibility
Sex/Gender
All
Age
18 Years to 100 Years
Inclusion criteria
Inclusion criteria: - Patients who were intubated and had received mechanical ventilation for at least 48 hours. -age > 18 years - clinical suspicion of VAP as defined by the ATS guidelines (new or progress pulmonary infiltration on CXR with two or more of the following: new or progress of fever; purulent sputum; WBC 12,000 cell/mm3); and simplified version of clinical pulmonary infection score > 6.
Exclusion criteria
Exclusion criteria: - pregnant - enrolled in another trial - had little chance of survival - had neutropenia (leukocyte counts 1 month) - had concomitant acquired immunodeficiency syndrome - had a concomitant extrapulmonary infection diagnosed between days 1 and 3 that required prolonged (>8 days) antibiotic treatment or infection caused by confirmed non-bacterial pathogens such as fungus or virus. - not received appropriate antibiotic within 3 days after enrollment - had unfavorable clinical response after 7 days of appropriate antibiotic treatment as defined by one of the following: body temperature >37.8°C; shock or use of inotropes or vasopressors; clinical pulmonary infection score >6.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Number of antibiotic-free days alive assessed 28 days after enrollment From the day of enrollment (the day of diagnosis of VAP) to day 28 after enrollment 28 - Total antibiotic exposure days,Number of antibiotic-free days alive assessed 28 days after enrollment From the day of enrollment (the day of diagnosis of VAP) to day 28 after enrollment count,Number of antibiotic-free days alive assessed 28 days after enrollment From the day of enrollment (the day of diagnosis of VAP) to day 28 after enrollment count,Number of antibiotic-free days alive assessed 28 days after enrollment From the day of enrollment (the day of diagnosis of VAP) to day 28 after enrollment count | — |
Secondary
| Measure | Time frame |
|---|---|
| relapse or superinfection rate, From the day of enrollment (the day of diagnosis of VAP) to day 28 after enrollment Patients were considered to have recurrent pneumonia when at least 1 bacterial species was reported ,number of mechanical ventilation-free days From the day of enrollment (the day of diagnosis of VAP) to day 28 after enrollment 28 - number of days without mechanical ventilation | — |
Countries
Thailand
Contacts
Public ContactPHUNSUP WONGSURAKIAT
Siriraj Hospital, Mahidol University
Outcome results
None listed