Routine Antibiotic Use Reduces ICU Deaths

Kathleen Blanchard's picture
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A very large study published in the New England Journal of Medicine shows that routine use of antibiotics in Intensive care units reduces the risk of death. The study comes from the University Medical Center (UMC) Utrecht, and included six thousand Dutch patients from thirteen hospitals.

The patients were expected to either spend three days in the ICU, or be on a ventilator (breathing machine) for two days, taking place between 2004 and 2006.

Three groups of patients received either an antibiotic paste applied orally four times a day, antibiotics through a gastric tube, intravenously, and with an oral paste, or routine ICU treatment.

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Fewer people died after four weeks when they received antibiotics. The study showed a 3.5% reduction ICU deaths in the patients heaviest hit with antibiotic therapy. None developed antibiotic resistance, but the study was of short-duration. Patients who received an oral antibiotic paste were 2.9% less likely to die.

First author of the study, Dr. Anne Marie de Smet, anesthesiologist-intensivist at UMC Utrecht, believes the research is conclusive – "I believe we should revise the antibiotic policy for the ICU. Because the study was conducted in thirteen Dutch hospitals, the conclusions can be implemented throughout the country. We have seen that using antibiotics clearly results in a reduction in the number of deaths, and ICUs should make use of this knowledge." To reach the conclusion that risk of ICU deaths decline with routine antibiotic use, the researchers divided patients into three groups.

The findings are significant, though likely to spawn further debate. A long-standing concern about antibiotic resistance has left the issue of routine antibiotic use in ICU patients up in the air. Antibiotic resistance is the subject of much discussion, as researchers have been scrambling to develop new classes of drugs to treat drug resistant infections, such as MRSA.

The research suggests that giving antibiotics to ICU patients to reduce deaths outweighs other concerns. The next step is to track how long it takes bacteria to become drug resistant.

Source: Fewer deaths with preventive antibiotics

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