VAP, frequently reported among intensive care unit (ICU)-admitted patients, is connected to poor outcomes, including hospitalizations and mortality. Despite VAP treatment guidelines, the ideal therapy period is unknown, particularly for NF-GNB-caused VAP. Previous research on individuals with non-NF-GNB VAP shown that short antibiotic regimens decreased the formation of resistant bacteria while not increasing the probability of mortality or recurrence.
Nevertheless, only two RCTs on patients with NF-GNB-caused VAP were included in the study, and only the abstract for one RCT was made accessible. The results also covered all hospital-acquired pneumonia subtypes. On the contrary, several studies have indicated increased risks of recurrence following short-course antibiotic treatment for NF-GNB-caused VAP.
Researchers assessed the incidence of VAP recurrence and relapse among patients receiving short-course and long-course antibiotic therapy in the current study.
The databases Embase, Cochrane Database of Systematic Reviews (CDSR), United States National Library of Medicine, National Institute of Health MEDLINE/PubMed, Web of Science, Google Scholar, and Cochrane Central Register of Controlled Trials (CENTRAL), published between 2000 and 1 September 2022, were searched for RCTs without regard to the language of the search terms.
A number of clinical trial registries, including the Australian New Zealand clinical trial registry, the currently controlled trial registry, Prospero registration, and the university hospital medical data network clinical trials registry, were also searched for active RCTs. Reference lists of included studies were also checked for the presence of additional RCTs.
The prime study endpoint was VAP recurrence and relapse, and secondary study endpoints included 28.0-day deaths, duration of mechanical ventilator support, extra-pulmonary infections, and the duration of intensive care unit stay. Random effects modeling was performed, and the odds ratios (ORs) were calculated. The team included randomized controlled trials that compared short-course vs. long-course of antibiotic treatment for VAP among adults from records of peer-reviewed scientific journals. Data from non-comparative analyses, reviews, abstracts, editorial letters, case series of <10 cases, and comments were not analyzed.