Prophylactic Antibiotics for Ventilator-Associated Pneumonia After Cardiac Arrest

Data from clinical trials suggest that patients who undergo therapeutic temperature management after cardiac arrest have excess risk for ventilator-associated pneumonia (VAP). French investigators randomized 194 patients who were undergoing therapeutic cooling (target, 32°C–34°C) for shockable out-of-hospital cardiac arrest to receive 2 days of either intravenous amoxicillin-clavulanate or placebo. Patients were assessed for VAP by clinical criteria and lower respiratory tract sampling (bronchoalveolar lavage or tracheal aspirate). One quarter of clinically diagnosed VAP cases were not confirmed by blinded adjudicators.

VAP within 7 days of admission was significantly less common in patients who received prophylactic antibiotics (19% vs. 34%…