To asses the impact of early nebulized antibiotics (ENA) on endotracheal tube colonization during MV before 96 hours.
All patients admitted to our medical/surgical ICU requiring MV at least for 4 days, without respiratory infections or prior antibiotic administration were evaluated. P were randomized to received ENA or placebo once a day (4 days). Bacteriological samples were collected at admission and repeated at 96 hours.
36 patients were evaluated, group A (14 p), at 24 hrs: 3(21%) negative, 8 (57.4%) normal flora, 2( 14.2%) S. Aureus meticilin sensible, 1 ( 7.14%) pneumococo. At 96 hrs: 3 (21%) negative, 3 (21%) S. Aureus meticilin sensible, 1(7.1%) pneumococo, 7 (49.7%) normal flora. Group S (13p): 4(30.4%) negative, 5(38%) normal flora , 2 (15.2%) S. Aureus meticilin sensible, 1(7.6%) E. Coli, 1 (7.6%) P. Aeuroginosa. At 96 hrs. 3(22.8%) A. Baumanii, 6(45.6%) P aeuroginosa, 1(7.6%) Klebsiella, 1(7.6%) S. Aureus meticilin sensible. In the group S, 95.7% of samples were colonized by potential pathogen microorganisms vs 28.4% in group A at 96 hrs (p=<0.005). Additionally at 96 hrs, any p of group A developed clinically early VAP, in group S two patients developed VAP on border time of study.CONCLUSIONS: 1.- In the Morelia experience, the use of antibiotics seems to control ET colonization with potential pathogen microorganism before 96 hours of MV.2.- Patients under antibiotics protocol did not developed early VAP during the study period.3.- Further clinical evaluation is mandatory to evaluate the really impact of ENA in reduction of PPM colonization and early VAP.
A promisory nebulized technique to avoid potential airway transcolonization by potential pathogen microorganism and limit additional risk factor to develop VAP
A. Maldonado, None.