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 to Ventilator Associated Pneumonia Care Bundle on Immunological Markers, MOHAMED A.M. EL-SAID, WALID HAMIMY, AHMED ZAGLOUL, AHMED MOKHTAR and HOSSAM EL-AZIZY
Abstract
Introduction: Ventilator-associated pneumonia (VAP) is the most important noso-comial 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 reduce the Immunological markers level which lead to better prognosis.
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 treatment group. Each dose of clarithromycin (klacid) (1g tablet) was grounded and administrated to the patient through the Ryle over the first three days after intubation (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 values of CRP (C-reactive protein) and IL-6 (interleukin 6) and TNF-a.
Results: The baseline values of both CRP (C-reactive protein) and IL-6 (interleukin 6) did not differ between the two groups on day 0. However the release of both CRP and IL-6 were significantly lower among clarithromycin treated patients than among placebo treated patients. On the other hand, the release of TNF-a at baseline before allocation to blinded treatment was significantly higher in group A than group B. However, on day 4 the release of TNF-a among clarithromycin treated patients was significantly lower than control group.
Conclusion: In conclusion, administration of clarithromy-cin for 3 days inhibits the level of Immunological markers.