Evgeni Brotfain1, Abraham Borer2, Lisa Saidel-Odes2, Leonid Koyfman1, Amit Frenkel1, Alexander Smolikov3, Shaun E Gruenbaum4, Alexander Zlotnik1, Moti Klein1. 1. Ben-Gurion University of the Negev Department of Anesthesiology and Critical Care, General Intensive Care Unit, Soroka Medical Center Beer Sheva Israel. 2. Ben-Gurion University of the Negev Department of Infectious Disease, Soroka Medical Center Beer Sheva Israel. 3. Ben-Gurion University of the Negev Department of Radiology, Soroka Medical Center Beer Sheva Israel. 4. Yale University School of Medicine Department of Anesthesiology New Haven, CT United States.
Abstract
INTRODUCTION: Percutaneous bedside tracheostomy (PBT) is a frequently done procedure in the intensive care unit (ICU). The rate of infectious complications and efficacy of perioperative therapy in reducing infections after PBT is currently unknown. METHODS: All demographic, clinical and microbiologic data was retrospectively collected from 110 cases of PBT performed in our ICU from 2006 to 2012. Of these patients, 82 patients received perioperative antibiotic therapy (Group 1, "antibiotic group") and 28 did not receive antibiotics (Group 2, "Non antibiotic group"). RESULTS: Patients who received antibiotic therapy had a lower incidence of new ventilator associated pneumonia (VAP) episodes [18% vs. 50 %, p = 0.001 (0.23, 0.87-0.13)]. There were no differences in the incidence of bacteremia or line sepsis. Overall Gram negative, Gram positive and fungal flora was similar in both groups before and after PBT. CONCLUSIONS: Our findings highlight the importance of conducting a prospective randomized control trial to better understand the role of antibiotic prophylaxis in PBT.
INTRODUCTION: Percutaneous bedside tracheostomy (PBT) is a frequently done procedure in the intensive care unit (ICU). The rate of infectious complications and efficacy of perioperative therapy in reducing infections after PBT is currently unknown. METHODS: All demographic, clinical and microbiologic data was retrospectively collected from 110 cases of PBT performed in our ICU from 2006 to 2012. Of these patients, 82 patients received perioperative antibiotic therapy (Group 1, "antibiotic group") and 28 did not receive antibiotics (Group 2, "Non antibiotic group"). RESULTS: Patients who received antibiotic therapy had a lower incidence of new ventilator associated pneumonia (VAP) episodes [18% vs. 50 %, p = 0.001 (0.23, 0.87-0.13)]. There were no differences in the incidence of bacteremia or line sepsis. Overall Gram negative, Gram positive and fungal flora was similar in both groups before and after PBT. CONCLUSIONS: Our findings highlight the importance of conducting a prospective randomized control trial to better understand the role of antibiotic prophylaxis in PBT.
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