Short-course versus prolonged-course antibiotic therapy for hospital-acquired pneumonia in critically ill adults
Citation: Pugh R, Grant C, Cooke RPD, et al. Short-course versus prolonged-course antibiotic therapy for hospital-acquired pneumonia in critically ill adults. Cochrane Database of Systematic Reviews 2015; (8): CD007577
What is this? Some patients with COVID-19 will become critically ill and need to be treated in an intensive care unit (ICU). Pneumonia is the most common hospital-acquired infection, particularly affecting patients in the ICU. Antibiotic courses of different lengths are used to treat it.
In this Cochrane systematic review, the authors searched for randomized trials comparing a ‘short’ duration of antibiotic therapy versus a ‘prolonged’ course for hospital-acquired pneumonia in critically ill adults, including those on mechanical ventilation who might develop ventilator-acquired pneumonia (VAP). They did not restrict by date or language of publication and did their searches in June 2015. They identified 6 eligible studies (1088 participants), but with substantial variation in how the included patients’ pneumonia was diagnosed or defined.
What works: For patients with VAP, courses of antibiotics lasting 7 or 8 days increase the number of antibiotic‐free days in the 4 weeks after treatment and reduce the recurrence of pneumonia compared with courses lasting 10 to 15 days, without increasing mortality or other recurrence outcomes.
What doesn’t work: For patients with VAP specifically due to non‐fermenting Gram‐negative bacilli (NF‐GNB), recurrence was greater after 8-day courses compared to courses lasting 10 to 15 days, but mortality outcomes were not significantly different.
What’s uncertain: Nothing noted.
Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence on the coronavirus (COVID-19) but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about the coronavirus (COVID-19) on the basis of this summary alone.