Abstract
BackgroundExcessive use of empirical antibiotics is common in critically ill patients. Rapid biomarker-based exclusion of infection may improve antibiotic stewardship in ventilator-acquired pneumonia (VAP). However, successful validation of the usefulness...
Highlights
Antibiotic resistance has been increasing rapidly, making antibiotic stewardship a priority for healthcare systems globally
The Ventilator-acquired pneumonia (VAP) group was associated with less use of antibiotics prior to bronchoalveolar lavage (BAL), less use of corticosteroids and a higher proportion of surgical patients, but only the first of these was statistically significant
The optimal cut-offs for IL-1β were similar in the 2 studies (10 vs 17 pg/mL), the small difference probably being explained by the lower volume of BAL instilled in this study (120 mL vs 200 mL)
Summary
Antibiotic resistance has been increasing rapidly, making antibiotic stewardship a priority for healthcare systems globally. ▸ To our knowledge, this is the first study to validate the effective, rapid exclusion of VAP using host proteins, paving the way for future trials assessing whether these markers can improve antibiotic stewardship in the intensive care unit. The diagnosis of VAP is challenging and pulmonary infection is confirmed in only approximately 30% of patients with suspected VAP.[3 4] Despite this, since VAP is associated with significant mortality and morbidity, and because significant delays in appropriate treatment have been linked to increases in mortality,[5] patients are often treated with antibiotics from the moment of initial suspicion This is compounded by the fact that conventional microbiology culture and sensitivity results typically take up to 72 h to return to clinicians. Successful validation of the usefulness of potential markers in this setting is exceptionally rare
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