Efficacy of the Addition of Clarithromycin t o Ventilator Associated Pneumonia Care Bundle to Help in Prevention of VAP in a Critical Care Unit
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- Category: Vol. 85, December 2017
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Efficacy of the Addition of Clarithromycin t o Ventilator Associated Pneumonia Care Bundle to Help in Prevention of VAP in a Critical Care Unit, MOHAMED A. MORSY EL-SAID, WALID HAMIMY, AHMED ZAGLOUL, AHMED MOKHTAR and HOSSAM EL-AZIZY
Abstract
Introduction: Ventilator-Associated Pneumonia (VAP) is the most important nosocomial infection among mechanically ventilated patients and the biggest worry of critical care physicians. We hypothesize that oral clarithromycin, as a member of the macrolides family, when added to the VAp care bundle will have better prevention role of ventilator associated pneumonia.
Methodology: This study included 80 patients, allocated randomly into two equal groups (40 patients in each group).
• Group A: The study drug was administered once daily by a nurse blind to treat-rent group. Each dose of clarithromycin (klacrd) (1g tablet) was grounded and administrated to the patient through the Ryle over the first three days after intu-bation (day one, day two and day three).
• Group B: Control group, placebo drug was administered once daily by a nurse blind to treatment group.
The outcomes that were investigated are Chest X-ray, TLC, Sputum and blood cultures that were performed at VAP diagnosis and seven days thereafter.
Results: Among the two groups, the diagnosis of VAP (Ventillator Associated Pneumonia) was established in 10 patients. The incidence of microbiologi-caily confirmed VAP in Group A was significantly lower than that of Group В (5% vs 20%, respectively, p0.043).
Seven patients had gram negative bacilli and three patients had gram positive Cocci. Klebsiella Pneumonia was the most common species (и=б), followed by methicillin-resistant staphylococcus aureus (n=2), and AcinetobacterbaumannH (n=2).
Conclusion: In conclusion, administration of clarithromycin for 3 days inhibitsthe incidence of VAP in mechanically ventilated patients.