Chastre VAP 8 vs 15

Comparison of 8 vs 15 Days of Antibiotic Therapy for VAP

Patient / Population Intervention / Exposure Comparison Outcome

In 401 patients with ventilator-associated pneumonia, 8 days of antibiotic therapy was non-inferior to 15 days for mortality and recurrence overall.

401

Design

Open-label non-inferiority RCT

Endpoint

28-day mortality and pulmonary infection recurrence

Relevance

ResultSimilar mortality and recurrence overall; higher recurrence in the 8-day arm only for non-fermenting Gram-negatives (notably P. aeruginosa).

Chastre J, et al. JAMA. 2003;290(19):2588-2598. 10.1001/jama.290.19.2588

Discussion & critique

Established the 7–8 day standard for most VAP; longer courses can be considered for P. aeruginosa pending newer data (iDIAPASON).