Effect of Antibiotic Prophylaxis on Early-Onset Pneumonia in Cardiac Arrest Patients Treated with Therapeutic Hypothermia

Abstract

Background: Infectious complications are frequent after cardiac arrest and a few reports have demonstrated that infections may be even more frequent after therapeutic hypothermia. Pneumonia is the most frequent infectious complication in these patient. Objectives: We investigated the effect of antibiotic prophylaxis on the development of pneumonia in cardiac arrest patients treated with therapeutic hypothermia. Methods: We retrospectively reviewed medical records of patients who admitted for therapeutic hypothermia after resuscitation of out-of-hospital cardiac arrest between January 2010 and December 2011. Patients dying within the first 72 hours were excluded. Results: Of the 46 patients admitted after cardiac arrest, 31 patients were analyzed and 24 patients (77%) were treated with prophylactic antibiotics within the 24 hours. The frequency of pneumonia in the first three days (early pneumonia) and after the third day (late pneumonia) was not significantly different between the prophylactic antibiotics group and the control group(33.3% vs 11.1% for early pneumonia, P=0.639; 50% vs 18.6% for late pneumonia, P=0.412). And the antibiotic prophylaxis did not also influence the length of ICU stay (19. 4 days in the prophylactic antibiotics group vs 16.4 days in the control group, P=0.659) and of mechanical ventilator (17.3 days in the prophylactic antibiotics group vs 12.7 days in the control group, P=0.372). Conclusion: Antibiotic prophylaxis in cardiac arrest patients treated with therapeutic hypothermia did not reduce the frequency of pneumonia.