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Prophylaxis of respiratory tract infection in patients on artificial respiration

M J Haverkorn1

  • 1Laboratory for Medical Microbiology, Eindhoven, The Netherlands.

European Heart Journal
|December 1, 1989
PubMed

Insights

This pilot study found that a prophylactic regimen of ciprofloxacin and amphotericin B effectively prevented respiratory tract infections in patients on mechanical ventilation. The treatment led to negative cultures for Gram-negative bacilli, suggesting a promising approach for intensive care units.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Pharmacology

Background:

  • Respiratory tract infections (RTIs) are a significant complication in mechanically ventilated patients.
  • Aerobic Gram-negative bacilli are common pathogens causing RTIs in intensive care units (ICUs).
  • Prophylactic strategies are crucial to mitigate infection risks in vulnerable patient populations.

Purpose of the Study:

  • To evaluate the efficacy of a prophylactic regimen combining ciprofloxacin and amphotericin B.
  • To prevent respiratory tract infections caused by aerobic Gram-negative bacilli in patients requiring prolonged mechanical ventilation.
  • To assess the safety and effectiveness of this regimen in a pilot study.

Main Methods:

  • A pilot study involving 102 consecutive patients on artificial respiration for ≥5 days.
  • Administration of ciprofloxacin (500 mg via gastric tube or 200 mg intravenously) twice daily.
  • Monitoring of fecal and throat cultures for aerobic Gram-negative bacilli.

Main Results:

  • Negative cultures for aerobic Gram-negative bacilli were observed in feces and throat, with only transient carriage.
  • No patients developed RTIs caused by Enterobacteriaceae or Pseudomonadaceae after 4 days of mechanical ventilation.
  • The regimen proved simple and effective compared to other prophylactic approaches.

Conclusions:

  • The prophylactic regimen of ciprofloxacin and amphotericin B shows significant promise in preventing RTIs in mechanically ventilated patients.
  • Further investigation in prospective, double-blind studies is warranted to confirm efficacy and monitor for resistance induction in ICUs.
  • This regimen represents a potentially simple and effective strategy for infection control in critical care settings.

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