The Effect of Blind-Protected Specimen Brush Sampling on Antibiotic Use in Patients with Suspected Ventilator-Associated Pneumonia

Abstract

The diagnosis of pneumonia in ventilated patients is exceedingly difficult. Although culture of tracheal aspirates have poor diagnostic value they are frequently used to diagnose ventilator-associated pneumonia (VAP). Recently a number of studies have reported on the diagnostic value of “blind” protected specimen brush (B-PSB) sampling in the diagnosis of VAP. B-PSB sampling can readily and safely be performed by respiratory care practitioners (RCPs). The aim of this study was to determine the cost-effectiveness of B-PSB sampling performed by respiratory therapists in patients with suspected VAP. During a 3-month run-in period, patients in our medical intensive care unit (MICU) with suspected VAP were treated based on clinical criteria and tracheal aspirate culture. Following this run-in period the house staff, nurses, and RCPs were prevented from sending tracheal aspirates for culture. All patients suspected of having VAP underwent B-PSB sampling with quantitative culture. The B-PSB sampling was performe...