dc.contributor
Institut Català de la Salut
dc.contributor
[Papiol E, Ruíz-Rodríguez JC, Ferrer R] Servei de Medicina Intensiva, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Grup de Recerca de Shock, Disfunció Orgànica i Ressuscitació, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain. [Berrueta J] Servei de Medicina Intensiva, Hospital Universitari Joan XXIII, Tarragona, Spain. Tarragona Health Data Research Working Group (THeDaR), Tarragona, Spain. [Manrique S, Claverias L] Servei de Medicina Intensiva, Hospital Universitari Joan XXIII, Tarragona, Spain
dc.contributor
Vall d'Hebron Barcelona Hospital Campus
dc.contributor.author
Papiol, Elisabeth
dc.contributor.author
Berrueta, Julen
dc.contributor.author
Manrique, Sara
dc.contributor.author
CLAVERIAS CABRERA, LAURA
dc.contributor.author
Ruiz-Rodriguez, Juan Carlos
dc.contributor.author
Ferrer, Ricard
dc.date.accessioned
2025-10-01T01:21:37Z
dc.date.available
2025-10-01T01:21:37Z
dc.date.issued
2025-09-22T11:54:45Z
dc.date.issued
2025-09-22T11:54:45Z
dc.identifier
Papiol E, Berrueta J, Ruíz-Rodríguez JC, Ferrer R, Manrique S, Claverias L, et al. Does Empirical Antibiotic Use Improve Outcomes in Ventilated Patients with Pandemic Viral Infection? A Multicentre Retrospective Study. Antibiotics (Basel). 2025 Jun;14(6):594.
dc.identifier
http://hdl.handle.net/11351/13714
dc.identifier
10.3390/antibiotics14060594
dc.identifier
001515677100001
dc.identifier.uri
http://hdl.handle.net/11351/13714
dc.description.abstract
Empirical antibiotic treatment; Pandemic viral pneumonia; Ventilator-associated pneumonia
dc.description.abstract
Tratamiento antibiótico empírico; Neumonía viral pandémica; Neumonía asociada a ventilación mecánica
dc.description.abstract
Tractament antibiòtic empíric; Pneumònia vírica pandèmica; Pneumònia associada a ventilació mecánica
dc.description.abstract
Background: During the influenza A(H1N1) and COVID-19 pandemics, empirical antibiotic treatment (EAT) was widely administered to critically ill patients despite low rates of confirmed bacterial co-infection (COI). The clinical benefit of this practice remains uncertain and may contradict antimicrobial stewardship principles. Objective: To evaluate whether EAT at ICU admission reduces ventilator-associated pneumonia (VAP) incidence or ICU mortality in critically ill patients with pandemic viral pneumonia, stratified by presence of COI. Methods: This retrospective analysis combined two national multicentre ICU registries in Spain, including 4197 adult patients requiring invasive mechanical ventilation for influenza A(H1N1) or COVID-19 between 2009 and 2021. Primary outcomes were ICU mortality and VAP incidence. Analyses were stratified by microbiologically confirmed bacterial COI. Propensity score matching, Cox regression, General Linear (GLM), and random forest models were applied. Results: Among patients without COI (n = 3543), EAT was not associated with lower ICU mortality (OR = 1.02, 95%CI 0.81–1.28, p = 0.87) or VAP (OR = 1.02, 95%CI 0.79–1.39, p = 0.89). In patients with confirmed COI (n = 654), appropriate EAT was associated with reduced VAP (17.4% vs. 36.3%, p < 0.001) and ICU mortality (38.4% vs. 49.6%, OR = 1.89, 95%CI 1.13–3.14, p = 0.03) compared to inappropriate EAT. Conclusions: EAT was not associated with a lower incidence of VAP or higher survival rates and could be harmful if administered incorrectly. These findings support a more targeted approach to antibiotic use, guided by microbiology, biomarkers and stewardship principles.
dc.description.abstract
Barri Casanovas Private Foundation Scholarship (FBC02/2024) (AR; MB).
dc.format
application/pdf
dc.relation
Antibiotics;14(6)
dc.relation
https://doi.org/10.3390/antibiotics14060594
dc.rights
Attribution 4.0 International
dc.rights
http://creativecommons.org/licenses/by/4.0/
dc.rights
info:eu-repo/semantics/openAccess
dc.subject
Unitats de cures intensives
dc.subject
Medicaments antiinfecciosos - Ús terapèutic
dc.subject
Respiració artificial
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COVID-19 (Malaltia)
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Virosis - Tractament
dc.subject
HEALTH CARE::Health Services Administration::Organization and Administration::Pharmacy Administration::Drug Utilization::Drug Utilization Review::Antimicrobial Stewardship
dc.subject
CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents
dc.subject
ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Equipment and Supplies::Ventilators, Mechanical
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Other subheadings::Other subheadings::Other subheadings::/adverse effects
dc.subject
HEALTH CARE::Health Care Facilities, Manpower, and Services::Health Facilities::Hospital Units::Intensive Care Units
dc.subject
DISEASES::Virus Diseases
dc.subject
DISEASES::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections
dc.subject
ATENCIÓN DE SALUD::administración de los servicios de salud::organización y administración::administración farmacéutica::utilización de medicamentos::revisión de la utilización de medicamentos::programas de optimización del uso de los antimicrobianos
dc.subject
COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antiinfecciosos::antibacterianos
dc.subject
TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::equipos y suministros::ventiladores mecánicos
dc.subject
Otros calificadores::Otros calificadores::Otros calificadores::/efectos adversos
dc.subject
ATENCIÓN DE SALUD::instalaciones, servicios y personal de asistencia sanitaria::centros sanitarios::unidades hospitalarias::unidades de cuidados intensivos
dc.subject
ENFERMEDADES::virosis
dc.subject
ENFERMEDADES::virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus
dc.title
Does Empirical Antibiotic Use Improve Outcomes in Ventilated Patients with Pandemic Viral Infection? A Multicentre Retrospective Study
dc.type
info:eu-repo/semantics/article
dc.type
info:eu-repo/semantics/publishedVersion
