Impact of Antibiotic Treatment on Outcome in Patients With Ventilator-Associated Tracheobronchitis

Not Applicable

Completed

• Conditions: Respiratory Tract Diseases; Nosocomial Infections

• Registration Number: NCT00122057
• Lead Sponsor: University Hospital, Lille

Brief Summary

The aim of this study is to determine whether antibiotic treatment could reduce mechanical ventilation duration in patients with nosocomial tracheobronchitis acquired under mechanical ventilation.

Detailed Description

Rationale:

Ventilator-associated tracheobronchitis (VAT) is common in intensive care unit (ICU) patients, rates of 2.7%-10.6% are reported in the literature. This nosocomial infection is associated with weaning difficulties resulting in prolonged duration of mechanical ventilation (MV) and ICU stay. A case-control study performed in chronic obstructive pulmonary disease (COPD) patients with VAT found antibiotic treatment to be significantly associated with reduced duration of MV. Another case control-study, performed in VAT patients without chronic respiratory failure, found no significant difference in duration of MV between patients who received adequate antibiotic treatment and those who received inadequate antibiotic treatment. In addition, antibiotic use is known to be associated with subsequent multidrug-resistant bacteria (MRB), longer duration of MV, and mortality rates. Therefore, a randomized controlled study is necessary to determine the impact of antibiotic treatment on outcome in VAT patients.

Patients and methods:

390 patients will be included in this prospective randomized open multicenter study. Inclusion of 390 patients is required to demonstrate a significant reduction of MV duration of 5 days (α = 0.025, β = 0.10). An intermediate analysis will be performed. All patients intubated and ventilated \> 48h who developed a first episode of VAT are eligible. Primary endpoint is the duration of MV. Secondary end points are ICU length of stay, mortality, ventilator-associated pneumonia, ICU-acquired infection, MRB, and yeast rates.

Study Timeline

• Study Start: 2005-06
• Study First Submitted: 2005-07-14
• Study First Submitted QC: 2005-07-14
• Study First Posted: 2005-07-21
• Status Verified: 2006-09
• Primary Completion: 2007-05
• Study Completion: 2007-06
• Last Update Submitted: 2011-05-31
• Last Update Posted: 2011-06-01

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 58

Inclusion Criteria

• Patients with tracheobronchitis diagnosed after 48h of invasive mechanical ventilation

Exclusion Criteria

• Immunodepressed patients
• Patients with tracheostomy at ICU admission
• Patients who developed ventilator-associated pneumonia before ventilator-associated tracheobronchitis

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
duration of mechanical ventilation

Secondary Outcome Measures

Name	Time	Method
length of intensive care unit (ICU) stay
mortality rate
ventilator-associated pneumonia rate

Trial Locations

Locations (1)

12 ICUs in north of France; 🇫🇷 Lille, France