1344. Macrolide use as prophylaxis for ventilator associated pneumonia
Session: Poster Abstract Session: Clinical Trials
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • Poster IDSA 1344.pdf (721.7 kB)
  • Background: Macrolides have shown beneficiary nonantibiotic effects in experimental studies and chronic pulmonary conditions, its efficacy to prevent ventilator-associated pneumonia (VAP) in patients on mechanical ventilation was tested.

    Methods: Twenty patients on mechanical ventilation without evidence of VAP were enrolled in a double-blind, randomized, single center trial from August 2011 until March 2012. Patients were assigned to one of three groups: (a) Azithromycin, (b) Clarithromycin, or (c) placebo. Patients received therapy for 14 days and observed closely. Main outcomes were development of VAP, time to development of VAP, duration of mechanical ventilation, and mortality.

    Results: The groups were well matched with regard to demographic characteristics, disease severity, and admission diagnosis. Analysis comprising the 20 patients enrolled in study revealed that 5 (71.43%) of patients who did not receive macrolide (n=7) developed VAP at a median time of 5 days. No patients on either macrolide showed evidence of VAP at the end of the observation period (p<0.004). It was also noted that patients on macrolides had fewer tracheal secretions when compared to control group. In addition, we observed that patients receiving macrolides had a median intubation time shorter than the control group (azithromycin: 3.4±1.7 days, clarithromycin: 8.8±3.6, and control: 14.5±11.0 days; p=0.035). There was no statistically significant difference for all-cause mortality between groups.

    Conclusion: Macrolides appear to be an effective method for prevention of VAP and accelerated weaning from mechanical ventilation in patients and improved their overall clinical state. The mortality rate at day 14 was not altered. Results are encouraging and render new perspectives on the management of patients on mechanical ventilations.

    Esteban Delpilar-Morales, MD, Infectious Disease Section, Internal Medicine Department, University of Puerto Rico, Medical Science Campus, San Juan, PR

    Disclosures:

    E. Delpilar-Morales, None

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