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Impact of Gram stain results on initial treatment selection in patients with ventilator-associated pneumonia: a retrospective analysis of two treatment algorithms

Not Applicable
Conditions
ventilator-associated penumonia
Registration Number
JPRN-UMIN000026457
Lead Sponsor
Osaka General Medical Centre
Brief Summary

Antimicrobial choices proposed by the Guideline based algorithm and the Gram stain based algorithm were appropriate in 94.7% and 92.4% of cases, respectively. McNemar's test showed no significant difference in adequacy for the different strategies (p = 0.221). The Gram stain based algorithm proposed anti-methicillin-resistant Staphylococcus aureus agents in significantly fewer episodes than the Guideline based algorithm (41 (31.3%) versus 92 (70.2%), respectively (p < 0.001)). The Gram stain based algorithm also recommended antipseudomonal agents in significantly fewer episodes than the Guideline based algorithm (68 (51.9%) versus 92 (70.2%), respectively (p < 0.001)).

Detailed Description

Not available

Recruitment & Eligibility

Status
Complete: follow-up complete
Sex
All
Target Recruitment
219
Inclusion Criteria

Not provided

Exclusion Criteria

modified clinical pulmonary infection score (CPIS) less than 5. semi-quantitative growth of a respiratory pathogen using a respiratory sample was estimated to be less than 1+.

Study & Design

Study Type
Observational
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
The coverage rates of initial antimicrobial therapies.
Secondary Outcome Measures
NameTimeMethod
The selected rates of anti-pseudomonal agents and anti-MRSA agents
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