ORBi: Damas Pierre - Combination therapy versus monotherapy: a randomised pilot study on the evolution of inflammatory parameters after ventilator associated pneumonia

Reference : Combination therapy versus monotherapy: a randomised pilot study on the evolution of inf...


	Document type :	Scientific journals : Article
	Discipline(s) :	Human health sciences : Anesthesia & intensive care
	To cite this reference:	http://hdl.handle.net/2268/73009

Title :	Combination therapy versus monotherapy: a randomised pilot study on the evolution of inflammatory parameters after ventilator associated pneumonia
Language :	English
Author, co-author :	Damas, Pierre [Université de Liège - ULg > > Soins intensifs >]
	Garweg, Christophe [Centre Hospitalier Universitaire de Liège - CHU > > Cardiologie >]
	Monchi, Mehran [> >]
	Nys, Monique [Centre Hospitalier Universitaire de Liège - CHU > > Soins intensifs - Anesthésie et réanimation >]
	Canivet, Jean-Luc [Centre Hospitalier Universitaire de Liège - CHU > > Soins intensifs >]
	Ledoux, Didier [Centre Hospitalier Universitaire de Liège - CHU > > Soins intensifs >]
	Preiser, Jean-Charles [Centre Hospitalier Universitaire de Liège - CHU > > Soins intensifs >]
Publication date :	2006
Journal title :	Critical Care: the Official Journal of the Critical Care Forum
Publisher :	BioMed Central
Volume :	10
Issue/season :	2
Pages :	R52
Audience :	International
ISSN :	1364-8535
e-ISSN :	1466-609X
City :	London
Country :	United Kingdom
Abstract :	[en] Introduction Combination antibiotic therapy for ventilator associated pneumonia (VAP) is often used to broaden the spectrum of activity of empirical treatment. The relevance of such synergy is commonly supposed but poorly supported. The aim of the present study was to compare the clinical outcome and the course of biological variables in patients treated for a VAP, using a monotherapy with a beta-lactam versus a combination therapy. Methods Patients with VAP were prospectively randomised to receive either cefepime alone or cefepime in association with amikacin or levofloxacin. Clinical and inflammatory parameters were measured on the day of inclusion and thereafter. Results Seventy-four mechanically ventilated patients meeting clinical criteria for VAP were enrolled in the study. VAP was microbiologically confirmed in 59 patients (84%). Patients were randomised to receive cefepime (C group, 20 patients), cefepime with amikacin (C-A group, 19 patients) or cefepime with levofloxacin (C-L group, 20 patients). No significant difference was observed regarding the time course of temperature, leukocytosis or C-reactive protein level. There were no differences between length of stay in the intensive care unit after infection, nor in ventilator free days within 28 days after infection. No difference in mortality was observed. Conclusion Antibiotic combination using a fourth generation cephalosporin with either an aminoside or a fluoroquinolone is not associated with a clinical or biological benefit when compared to cephalosporin monotherapy against common susceptible pathogens causing VAP.
Target :	Researchers ; Professionals
Permalink :	http://hdl.handle.net/2268/73009

File(s) associated to this reference

Fulltext file(s):

	File	Commentary	Version	Size	Access
Open access	88.pdf		Publisher postprint	214.62 kB	View/Open

All documents in ORBi are protected by a user license.

Dspace v1.5