Prevention of pneumonia in an intensive care unit: a randomized multicenter clinical trial

M. Mandelli, P. Mosconi, M. Langer, M. Cigada, G. Arosio, F. Bassi, B. Beffagna, G. C. Caroli, R. Citterio, A. Cusenza, V. Emmi, P. Ferrero, G. Gallioli, P. Lupi, R. Malacrida, G. Mascotto, C. Minella, P. Molinaroli, F. Motta

Research output: Contribution to journalArticle

Abstract

In a randomized multicenter clinical trial on antibiotic prophylaxis, 1,319 patients in 23 ICUs were enrolled over a 4-month period. The end-point of the study was the prevention of early onset pneumonia (EOP), defined as acquired pneumonia diagnosed within 4 days of ICU admission; this accounted for > 50% of overall pneumonia. Patients eligible for the study were divided into three groups which received either cefoxitin (2 g iv for three doses/8 h), penicillin G (2 million U iv for four doses/6 h), or no antibiotic (control group). In the overall population, the incidence of EOP was 6.1% in the prophylaxis recipients vs. 7.2% in the control group (a 15.3% reduction). No statistically different rates of pneumonia or death were found among the groups. Patients with impaired reflexes on admission or prolonged ventilatory support were noted to have a lower incidence of EOP and an improved outcome when treated with cefoxitin.

Original languageEnglish
Pages (from-to)501-505
Number of pages5
JournalCritical Care Medicine
Volume17
Issue number6
Publication statusPublished - 1989

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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    Mandelli, M., Mosconi, P., Langer, M., Cigada, M., Arosio, G., Bassi, F., Beffagna, B., Caroli, G. C., Citterio, R., Cusenza, A., Emmi, V., Ferrero, P., Gallioli, G., Lupi, P., Malacrida, R., Mascotto, G., Minella, C., Molinaroli, P., & Motta, F. (1989). Prevention of pneumonia in an intensive care unit: a randomized multicenter clinical trial. Critical Care Medicine, 17(6), 501-505.