The PROPHY-VAP study, a multicenter, randomized trial in eight French hospitals, evaluated the efficacy of a single dose of ceftriaxone in preventing early ventilator-associated pneumonia (VAP) in 319 mechanically ventilated, comatose patients with acute brain injury. Patients were assigned to either ceftriaxone or placebo groups. The study found a significant reduction in early VAP incidence in the ceftriaxone group (14%) compared to the placebo group (32%), with no adverse effects. This led to the recommendation of including ceftriaxone in VAP prevention protocols for such patients.
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This used single ceftriaxone dose 2g within 12 hours of intubation. It targets eliminating colonisation in orotracheal tree to decrease VAP incidence in pt with high risk for aspiration(stroke, TBI, ICH, SAH)
. It shows less early VAP,less ventilated days, fewer ICU days, less abx usage, fewer Hopitalisation days, delayed VAP onset in ceftriaxone arm, and only two pt showed ESBL in rectal swab upon discharge in ceftriaxonearm.
The microbiological showed majority of polymicrobial yield
They included GCS 3 - 12 (majority were 4 - 8)
Thanks for sharing, Dr. Mazen