Early-onset Ventilator-associated Pneumonia in Adults: Comparison of 8 Versus 15 Days of Antibiotic Treatment
Pneumonia Ventilator Associated
About this trial
This is an interventional treatment trial for Pneumonia Ventilator Associated focused on measuring Antibiotic, treatment, ventilator associated pneumonia, duration
Eligibility Criteria
Inclusion Criteria:
Early onset nosocomial pneumonia in patients under mechanical ventilation since at least 24 h Patients aged 18 years or more The patient must be able to receive either one of the two arms of treatment defined for the study Information on the patient and his family informed consent obtained during the first three days Bacteria sensitive to the specified antibiotic regimen
Exclusion Criteria:
- Patients do not match the criteria for inclusion
- 18 years of age, pregnant Patients
- Another infectious outbreak documented the day of the BAL.
- Patients with acquired immunosuppression (blood diseases, HIV,...), induced (immunosuppressive drugs, cancer, radiation therapy) or congenital.
- Steroids for a period exceeding 15 days.
- Leukopenia (1000 GB/mm (or neutropenia (500 PN/mm)
- Purulent pleural effusion, pulmonary abscess
- Cystic fibrosis
Antibiotic treatment according to the following terms:
- Ongoing curative antibiotic therapy
- Antibiotics within 3 days before the diagnosis of VAP, except surgical antibiotic prophylaxis (defined according to the consensus conference "antibiotic prophylaxis in the surgical environment in adult" December 11, 1992) (27)
- Use of antibiotics not authorized in the study (see list)
- Allergy to antibiotics used in the study
- Inclusion in another study assessing antibiotic treatment, either the treatment or prevention of nosocomial pulmonary disease
- Refusal to participate
- Lack of informed consent by the patient or his family
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
8 days of antibiotic treatment
15 days antibiotic treatment
Patients will receive a combination antibiotic during 5 days and then 3 days of a single Beta Lactam antibiotic
All patients included in the study will be treated by a combination of antibiotics during the first 5 days, then by monotherapy for 10 days according to the group. The beta-lactam antibiotics will be administered in high doses during the first 3 days of treatment. Aminoglycosides will be administered in a single daily dose, with a loading dose the first day of treatment.