Efficacy of antibiotic prophylaxis against ventilator-associated pneumonia.

Ventilator-associated pneumonia (VAP) is one of the most important problems of intensive care units. Eighty-four neurologic patients with acute stroke (Glasgow Coma Score ≤8) were entered into a double-blind clinical trial. Patients in the intervention group received piperacillin-tazobactam 4 g/0.5 g at the time of intubation and 12 h later. The incidences of early-onset (within four days of intubation) and late-onset VAP were 9.2 and 26.9 episodes per 1000 days of mechanical ventilation in the intervention and control groups, respectively (odds ratio: 0.217; 95% confidence interval: 0.056-0.085; P = 0.028). Administration of prophylactic piperacillin-tazobactam may reduce early-onset VAP, but the benefit does not extend to late-onset VAP.