2023, Number 3
Relationship between prehospital antibiotic therapy and ventilator Associated Pneumonia in COVID-19
Full text
10.35366/111299
Language: Spanish
References: 21
Page: 224-228
PDF size: 161.11 Kb.
ABSTRACT
Introduction: the indiscriminate use of antibiotic therapy in patients with COVID-19 became a common medical practice during the pandemic. In the context of critical illness due to COVID-19, a greater appearance of infections associated with mechanical ventilation has been observed. It is therefore necessary to determine what role the use of antibiotics plays in the prehospital phase empirically in the appearance of pneumonia associated with mechanical ventilation. Objectives: to determine if the prehospital administration of antibiotics had any relationship with the development of pneumonia associated with mechanical ventilation as well as with the mortality of critically ill patients with COVID-19. Material and methods: cohort, retrospective and longitudinal study. Data were obtained from adult patients admitted to the intensive care unit of a tertiary hospital with a diagnosis of COVID-19, who required invasive mechanical ventilation from March 1, 2021 to February 28, 2022. The patients were classified according to with the criterion of having received or not, antibiotic treatment in the prehospital phase. Results: 58 patients were selected, of which 34 were women and 24 men, the average age was 57.7 years. A statistically significant difference was found in the occurrence of ventilator-associated pneumonia in the group of patients who received prehospital antimicrobial therapy (p < 0.001). The most frequent microorganisms isolated by culture of bronchial secretions in the group of patients who received prehospital antibiotics were in order of frequency: Acinetobacter baumannii 27.5%, Klebsiella pneumoniae 12.5%, Pseudomonas aeruginosa 12.5%, Stenotrophomonas maltophilia 5%. Conclusion: in critically ill patients with COVID-19, the empirical use of antibiotics in the prehospital phase is related to a greater probability of developing pneumonia associated with mechanical ventilation, specifically due to bacteria, with Acinetobacter baumannii as the most frequent etiological agent. Empiric prehospital use of antibiotics increases the chances of death in critically ill patients with COVID-19.REFERENCES
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