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Prophylactic Antimicrobial Therapy for AAP

Clin Infect Dis; ePub 2018 Feb 9; Dragan, et al

For patients with acute aspiration pneumonitis (AAP), prophylactic antimicrobial therapy does not offer clinical benefit and may generate antibiotic selective pressures that results in the need for escalation of antibiotic therapy, a recent study found. The retrospective cohort study assessed outcomes of patients receiving antimicrobial prophylaxis with those receiving supportive care only during the initial 2 days following an AAP episode. The primary outcome was in-hospital mortality within 30 days; secondary outcomes included transfer to critical care. Researchers found:

  • Among 1,483 patients reviewed, 200 met criteria for AAP including 76 (38%) who received prophylactic antimicrobial therapy and 124 (62%) receiving supportive management only.
  • Unadjusted in-hospital mortality was similar between the groups.
  • Patients receiving antimicrobial prophylaxis were no less likely to require transfer to critical care and received more frequent escalation of antibiotic therapy and fewer antibiotic-free days.
  • Antimicrobial prophylaxis was not associated with any improvement in mortality after adjustment.

Citation:

Dragan V, Wei L, Elligsen M, Kiss A, Walker SAN, Leis JA. Prophylactic antimicrobial therapy for acute aspiration pneumonitis. [Published online ahead of print February 9, 2018]. Clin Infect Dis. doi:10.1093/cid/ciy120.

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