Korean J Crit Care Med.  2016 Feb;31(1):17-24. 10.4266/kjccm.2016.31.1.17.

Effect of Antibiotic Prophylaxis on Early-Onset Pneumonia in Cardiac Arrest Patients Treated with Therapeutic Hypothermia

• Kim SJ
• Lee JK
• Kim DK
• Shin JH
• Hong KJ
• Heo EY

• KMID: 2227608
• DOI: http://doi.org/10.4266/kjccm.2016.31.1.17

Abstract

BACKGROUND
Infectious complications frequently occur after cardiac arrest and may be even more frequent after therapeutic hypothermia. Pneumonia is the most common infectious complication associated with therapeutic hypothermia, and it is unclear whether prophylactic antibiotics administered during this intervention can decrease the development of early-onset pneumonia. We investigated the effect of antibiotic prophylaxis on the development of pneumonia in cardiac arrest patients treated with therapeutic hypothermia.
METHODS
We retrospectively reviewed the medical records of patients who were admitted for therapeutic hypothermia after resuscitation for out-of-hospital cardiac arrest between January 2010 and July 2015. Patients who died within the first 72 hours or presented with pneumonia at the time of admission were excluded. Early-onset pneumonia was defined as pneumonia that developed within 5 days of admission. Prophylactic antibiotic therapy was defined as the administration of any parenteral antibiotics within the first 24 hours without any evidence of infection.
RESULTS
Of the 128 patients admitted after cardiac arrest, 68 were analyzed and 48 (70.6%) were treated with prophylactic antibiotics within 24 hours. The frequency of early-onset pneumonia was not significantly different between the prophylactic antibiotic group and the control group (29.2% vs 30.0%, respectively, p = 0.945). The most commonly used antibiotic was third-generation cephalosporin, and the class of prophylactic antibiotics did not influence early-onset pneumonia.
CONCLUSION
Antibiotic prophylaxis in cardiac arrest patients treated with therapeutic hypothermia did not reduce the frequency of pneumonia.

Keyword

antibiotic prophylaxis; hypothermia; pneumonia

MeSH Terms

Anti-Bacterial Agents
Antibiotic Prophylaxis*
Heart Arrest*
Humans
Hypothermia*
Medical Records
Out-of-Hospital Cardiac Arrest
Pneumonia*
Resuscitation
Retrospective Studies
Anti-Bacterial Agents

Reference

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