ICU Survival can be improved by Antibiotic use

Intensive care unit patients who receive a preventative round of antibiotics aimed at ridding their digestive tract of harmful bacteria are more likely to survive their ICU stay.

That’s the finding from a new study that compared results between ICU patients who were given antibiotics and those who received usual care.

The practice of giving ICU patients antibiotics to kill harmful bacteria in the mouth, stomach, and intestines was first introduced in 1984 in an effort to curtail deadly hospital-acquired infections, which are common in ICUs. Noting most hospital-acquired infections are preceded by other bacterial infections, researchers theorized killing the bacteria might stop the deadly infections in their tracks.

However, in recent years, fears that overuse of antibiotics could foster the development of antibiotic-resistance bacteria have raised concerns.

The current study involved 934 ICU patients who were randomly assigned to one of the two treatment groups. All were on a respirator, which greatly increases the risk of getting a hospital-acquired infection. Results showed 15 percent of those in the antibiotic group died while still in the ICU compared to 23 percent in the usual care group.

The practice benefited patients even after they were transferred to a regular hospital unit. Researchers noted a hospital death rate of 24 percent among patients who received the drugs, compared with 31 percent among those who did not.

A very low rate of antibiotic-resistant bacteria was seen in the patients as well, suggesting the use of preventive antibiotics is safe in ICUs with a low prevalence of antibiotic-resistant bacteria.

The authors conclude preventive antibiotics are appropriate for all ICU patients who are likely to be on mechanical ventilation for at least two days or in the ICU for at least three days, provided they are being treated in an ICU with a low incidence of antibiotic-resistant bacteria.