Fewer ICU deaths with preventive antibiotic use
January 4, 2009
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During the study, a team of researchers compared the effect of two kinds of antibiotic treatments with the standard ICU care. They divided into three groups nearly six thousand patients hospitalized in ICUs between 2004 and 2006. The patients in question were expected to be on a ventilator for at least two days and/or to be admitted to the ICU for at least three days. One of the groups received an oral antibiotic paste four times a day. The second group, in addition to being given the oral paste four times daily, received antibiotics through a gastric tube in the intestinal tract and by intravenous drip. The third group was the control group and received the standard ICU care.
After four weeks, fewer people had died in the groups that received antibiotics than in the control group. Preventive use of antibiotics reduced the number of deaths by 3.5 percent (oral antibiotic paste, and antibiotics in the intestinal tract and by intravenous drip) and 2.9 percent (oral antibiotic paste). The difference between the two groups treated with antibiotics was not significant. The number of antibiotic-resistant bacteria did not increase in these patients. Although the patients in the control group were in general slightly less sick, the statistical data were adjusted to reflect this.
The findings have settled a long-running debate on whether the advantages of using antibiotics as a preventive measure offset the drawback of the possibility of developing antibiotic resistance. For Dr. Anne Marie de Smet, anesthesiologist-intensivist at UMC Utrecht and the article’s first author, the conclusion is clear.
“We have seen that using antibiotics clearly results in a reduction in the number of deaths, and ICUs should make use of this knowledge,” de Smet said.
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