Profound effect of study design factors on ventilator-associated pneumonia incidence of prevention studies: benchmarking the literature experience

2008 ◽  
Vol 61 (5) ◽  
pp. 1154-1161 ◽  
Author(s):  
James C. Hurley
Keyword(s):  
Study Design ◽  
Ventilator Associated Pneumonia ◽  
Prevention Studies ◽  
Design Factors

Comparison of 8 versus 15 Days of Antibiotic Therapy for Ventilator-Associated Pneumonia in Adults

2018 ◽  
pp. 257-262
Author(s):  
Laurie O. Mark ◽  
Jean Kwo
Keyword(s):  
Antibiotic Therapy ◽  
Randomized Trial ◽  
Study Design ◽  
Clinical Case ◽  
Pulmonary Infection ◽  
Ventilator Associated Pneumonia ◽  
Icu Patients ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of the landmark study “Comparison of 8 versus 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial.” In adult patients with ventilator-associated pneumonia (VAP), is treatment with an 8-day course of antimicrobials as effective as a 15-day course? Starting with that question, the chapter describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case. In ICU patients who develop microbiologically proven VAP, an 8-day antimicrobial course is not inferior to a 15-day course with respect to all-cause mortality or recurrence of pulmonary infection. However, these findings may not apply to patients who are immunocompromised, and shorter or longer duration of antibiotics may sometimes be indicated.

scholarly journals The Barcelonabeta dementia prevention research clinic: Study design, recruitment profiles and inclusion in prevention studies — An update

2020 ◽  
Vol 16 (S10) ◽  
Author(s):  
Karine Fauria ◽  
Carolina Minguillón ◽  
Marta Félez‐Sánchez ◽  
Sofia Menezes‐Cabral ◽  
Gonzalo Sánchez‐Benavides ◽  
...  
Keyword(s):  
Study Design ◽  
Prevention Research ◽  
Dementia Prevention ◽  
Prevention Studies ◽  
Clinic Study

scholarly journals Development of a Questionnaire to Investigate Study Design Factors Influencing Participation in Gait Rehabilitation Research by People with Stroke: A Brief Report

2015 ◽  
Vol 67 (3) ◽  
pp. 240-244
Author(s):  
Kara K. Patterson ◽  
Nicole Gallant ◽  
Tracey Ormiston ◽  
Chad Patience ◽  
Mandy Whitechurch ◽  
...  
Keyword(s):  
Study Design ◽  
Gait Rehabilitation ◽  
Rehabilitation Research ◽  
Factors Influencing ◽  
Design Factors

Estimating the attributable mortality of ventilator-associated pneumonia from randomized prevention studies*

2011 ◽  
Vol 39 (12) ◽  
pp. 2736-2742 ◽  
Author(s):  
Wilhelmina G. Melsen ◽  
Maroeska M. Rovers ◽  
Mirelle Koeman ◽  
Marc J. M. Bonten
Keyword(s):  
Attributable Mortality ◽  
Ventilator Associated Pneumonia ◽  
Prevention Studies

scholarly journals P1-535: THE BARCELONAβETA DEMENTIA PREVENTION RESEARCH CLINIC: STUDY DESIGN, RECRUITMENT PROFILES AND PARTICIPANTS INCLUSION IN PREVENTION STUDIES

2019 ◽  
Vol 15 ◽  
pp. P475-P476
Author(s):  
Carolina Minguillon ◽  
Sofia Menezes-Cabral ◽  
Marta Félez-Sánchez ◽  
Carolina Herrero ◽  
Gonzalo Sánchez-Benavides ◽  
...  
Keyword(s):  
Study Design ◽  
Prevention Research ◽  
Dementia Prevention ◽  
Prevention Studies ◽  
Clinic Study

Inapparent Outbreaks of Ventilator-Associated Pneumonia An Ecologic Analysis of Prevention and Cohort Studies

2005 ◽  
Vol 26 (4) ◽  
pp. 374-390 ◽  
Author(s):  
James C. Hurley
Keyword(s):  
Cohort Study ◽  
Regression Models ◽  
Study Groups ◽  
Cross Infection ◽  
Ventilator Associated Pneumonia ◽  
Reference Standard ◽  
Control Groups ◽  
Prevention Studies ◽  
Cohort Groups ◽  
Linear Regressions

AbstractObjective:To compare ventilator-associated pneumonia (VAP) rates and patterns of isolates across studies of antibiotic and non-antibiotic methods for preventing VAP.Design:With the use of 42 cohort study groups as the reference standard, the prevalence of VAP was modeled in two linear regressions: one with the control groups and the other with the intervention groups of 96 VAP prevention studies. The proportion of patients admitted with trauma and the VAP diagnostic criteria were used as ecologic correlates. Also, the patterns of pathogenic isolates were available for 117 groups.Results:In the first regression model, the VAP rates for the control groups of antibiotic-based prevention studies were at least 18 (CI95, 12 to 24) per 100 patients higher than those in the cohort study groups (P< .001). By contrast, comparisons of cohort study groups with all other control and intervention groups in the first and second regression models yielded differences that were less than 6 per 100 and not significant (P> .05). For control groups with VAP rates greater than 35%, the patterns of VAP isolates, such as the proportion ofStaphylococcus aureus,more closely resembled those in the corresponding intervention groups than in the cohort groups.Conclusions:The rates of VAP in the control groups of the antibiotic prevention studies were significantly higher than expected and the patterns of pathogenic isolates were unusual. These observations suggest that inapparent outbreaks of VAP occurred in these studies. The possibility remains that antibiotic-based VAP prevention presents a major cross-infection hazard.

scholarly journals Asymmetric Effects of Decontamination Using Topical Antibiotics for the ICU Patient

Symmetry ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1027
Author(s):  
James C. Hurley
Keyword(s):  
Infection Prevention ◽  
Natural Experiment ◽  
Antibiotic Use ◽  
Ventilator Associated Pneumonia ◽  
Control Groups ◽  
Topical Antibiotic ◽  
Topical Antibiotics ◽  
Concurrent Control ◽  
Asymmetric Effects ◽  
Prevention Studies

There are several antiseptic, antibiotic and non-decontamination-based interventions for preventing intensive care unit (ICU) acquired infection. These have been evaluated in >200 studies. Infection prevention using topical antibiotic prophylaxis (TAP) appears to be the most effective. Whether antibiotic use in the ICU may influence the risk of infection among concurrent control patients within the same ICU and result in asymmetrical herd effects cannot be resolved with individual studies examined in isolation. The collective observations within control and intervention groups from numerous ICU infection prevention studies simulates a multi-center natural experiment enabling the herd effects of antibiotics to be evaluated. Among the TAP control groups, the incidences for both ventilator associated pneumonia (VAP) and mortality are unusually high in comparison to literature-derived benchmarks. Paradoxically, amongst the TAP intervention groups, the incidences of mortality are also unusually high and the VAP incidences are similar (i.e., not lower) compared to the incidences among studies of other interventions. By contrast, the mortality incidences among the intervention groups of other studies are similar to those among the intervention groups of TAP studies. Using topical antibiotics to prevent infections acquired within the ICU environment may result in profoundly asymmetrical effects.

Attributable mortality of ventilator-associated pneumonia: a meta-analysis of individual patient data from randomised prevention studies

2013 ◽  
Vol 13 (8) ◽  
pp. 665-671 ◽  
Author(s):  
Wilhelmina G Melsen ◽  
Maroeska M Rovers ◽  
Rolf HH Groenwold ◽  
Dennis CJJ Bergmans ◽  
Christophe Camus ◽  
...  
Keyword(s):  
Individual Patient Data ◽  
Meta Analysis ◽  
Patient Data ◽  
Attributable Mortality ◽  
Ventilator Associated Pneumonia ◽  
Prevention Studies
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