Impact of Ceftriaxone on the Incidence of Early VAP in Patients With TBI and Multisystem Trauma

A single dose of ceftriaxone is associated with reduced incidence of early ventilator-associated pneumonia (VAP) and decreased antibiotic exposure in patients with isolated head injury, but the impact in patients with multisystem trauma is unknown. This was a single-center, retrospective cohort study conducted in mechanically ventilated, multisystem trauma patients who were admitted to the intensive care unit (ICU) between September 2020 and September 2024. Patients who received one dose of ceftriaxone within 12 h of intubation were included in the early ceftriaxone group. Early VAP occurred in 3 (10%) patients in the early ceftriaxone group and 15 (25%) patients in the deferred or no antibiotics group (P = .10). No differences in secondary outcomes were identified. In patients who received early ceftriaxone in this cohort, there was no difference in early VAP incidence compared to those who had no or deferred antibiotics past 12 h of intubation; however, the study may have lacked sufficient power to detect a difference. Future, larger studies in multisystem trauma patients are needed to better delineate the impact of prophylactic antibiotics on VAP outcomes.