Impact of the Duration of Antibiotics on Clinical Events in Patients With Pseudomonas Aeruginosa Ventilator-associated Pneumonia (iDIAPASON) (iDIAPASON)
Ventilator-Associated Pneumonia
About this trial
This is an interventional treatment trial for Ventilator-Associated Pneumonia focused on measuring Ventilator Associated, Pneumonia, Antibiotic treatment, Pseudomonas aeruginosa
Eligibility Criteria
Inclusion Criteria:
- Patients older than 18 years
- Mechanical ventilation ≥ 48 hours
Documented Pseudomonas aeruginosa ventilator-associated pneumonia:
- Clinical suspicion (≥ two criteria including: fever> 38.5°C,leukocytosis > 10 Giga/L or leukopenia < 4 Giga/L, purulent tracheobronchial secretions and a new or persistent infiltrate on chest radiography).
- Documented Pseudomonas aeruginosa positive quantitative culture of a respiratory sample: bronchoalveolar lavage fluid (significant threshold, >104cfu/ml) or plugged telescopic catheter (significant threshold, >103cfu/ml) or quantitative endotracheal aspirate (significant threshold, >106cfu/ml).
- Written informed consent
- Patient affiliated to French social security
Exclusion Criteria:
- Immunocompromised patients (HIV, immunosuppressive therapy, corticosteroids> 0.5 mg / kg per day for more than a month)
- Patients receiving antibiotic therapy for extrapulmonary infection
- Patients in whom a procedure of withdrawing life-sustaining treatment has been established
- Pregnancy
- Patients included in another interventional study
- Chronic pulmonary colonization with Pseudomonas aeruginosa: patients with Chronic Obstructive Pulmonary Disease (COPD) or bronchiectasis, with a positive respiratory sample at infra threshold rate for Pseudomonas aeruginosa (ie<103 CFUs/mL for protected specimen brush or <106 CFUs/mL for tracheal aspirate), obtained in the absence of pneumonia or exacerbation during the 6 months before the ICU admission.
- Patient under guardianship or curatorship
Sites / Locations
- Anesthesiology and Critical Care Medicine Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière
Arms of the Study
Arm 1
Arm 2
Experimental
Sham Comparator
8 days of effective antibiotic treatment
15 days of effective antibiotic treatment
Antibiotic treatment should be started just after realization of bacteriological sampling, and then converted into a narrow-spectrum therapy, based on culture results, for a total duration of effective antibiotic therapy against PA of 8 days.
Antibiotic treatment should be started just after realization of bacteriological sampling, and then converted into a narrow-spectrum therapy, based on culture results, for a total duration of effective antibiotic therapy against PA of 15 days.