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4CPS-151 Analysis of antibiotic treatment in patients with ventilator associated pneumonia
  1. B Torrecilla Vall-Llossera1,
  2. L Gras Martín1,
  3. P Vera Artázcoz2,
  4. AP Cortes Palacios2,
  5. E Fernandez De Gamarra Martinez1
  1. 1Hospital De La Santa Creu I Sant Pau, Pharmacy Department, Barcelona, Spain
  2. 2Hospital De La Santa Creu I Sant Pau, Intensive Care Unit Department, Barcelona, Spain


Background and Importance Pneumonia is the main infectious complication in patients with mechanical ventilation. Early adequate empirical therapy is an important determinant of clinical outcome. Once the pathogen has been identified, empirical treatment must be adjusted to the drugs with the narrowest spectrum and for the shortest time.

Aim and Objectives To describe the antibiotic treatment of patients with ventilator-associated pneumonia (VAP) and evaluate whether it was appropriate according to the hospital protocols (choice of empirical treatment and duration).

Material and Methods An observational, retrospective and multidisciplinary analysis in a tertiary hospital was performed. All patients with VAP during a year (January-December 2022) were included. Variables collected were: demographics, treatment, duration and clinical outcome (exitus or not). Appropriate treatment was considered when piperacillin/tazobactam, cefepime or meropenem (+/- amikacin) were prescribed for 7–15 days, according to hospital protocols.

A descriptive statistical analysis was done with measures of central tendency and dispersion.

Results Antibiotic treatments of 32 patients with VAP were analysed (81% men, mean age: 61 years old). Empirical treatments were piperacillin/tazobactam (n=23), cefepime (n=2) and meropenem (n=7), in many cases associated to amikacin, according to hospital protocols.

All patients received appropriate treatment considering the identified pathogen. Staphylococcus aureus (n=6), Klebsiella pneumoniae (n=6), Pseudomonas aeruginosa (n=5) and Serratia marcescens (n=4) were the most frequent microorganisms.

The average duration in this study was 14 days (SD:9, median:11), which is within the range established for VAP in the hospital protocols.

Most patients (n=23, 72%) were treated for 15 or fewer days. Three patients died in the first five days of treatment and five patients received antibiotic treatment for 7–9 days. In some cases (n=9, 28%) treatments were prolonged for more than 15 days. Six of them received antibiotics for 16–21 days and in the remaining three cases antimicrobials were prescribed for 26, 40 and 50 days due to clinical complications and the presence of extremely resistant microorganisms.

Conclusion and Relevance Empirical treatments for VAP were appropriated according to hospital protocols. Although in general length of treatment ranged between 7–15 days there were some exceptions in which this duration needed to be prolonged. An effort should be made to establish shorter duration when possible.

Conflict of Interest No conflict of interest.

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