PMID- 35552788
OWN - NLM
STAT- MEDLINE
DCOM- 20220713
LR  - 20221216
IS  - 1432-1238 (Electronic)
IS  - 0342-4642 (Linking)
VI  - 48
IP  - 7
DP  - 2022 Jul
TI  - Comparison of 8 versus 15 days of antibiotic therapy for Pseudomonas aeruginosa 
      ventilator-associated pneumonia in adults: a randomized, controlled, open-label 
      trial.
PG  - 841-849
LID - 10.1007/s00134-022-06690-5 [doi]
AB  - PURPOSE: Duration of antibiotic therapy for ventilator-associated pneumonia (VAP) 
      due to non-fermenting Gram-negative bacilli (NF-GNB), including Pseudomonas 
      aeruginosa (PA) remains uncertain. We aimed to assess the non-inferiority of a 
      short duration of antibiotics (8 days) vs. prolonged antibiotic therapy (15 days) 
      in VAP due to PA (PA-VAP). METHODS: We conducted a nationwide, randomized, 
      open-labeled, multicenter, non-inferiority trial to evaluate optimal duration of 
      antibiotic treatment in PA-VAP. Eligible patients were adults with diagnosis of 
      PA-VAP and randomly assigned in 1:1 ratio to receive a short-duration treatment 
      (8 days) or a long-duration treatment (15 days). A pre-specified analysis was 
      used to assess a composite endpoint combining mortality and PA-VAP recurrence 
      rate during hospitalization in the intensive care unit (ICU) within 90 days. 
      RESULTS: The study was stopped after 24 months due to slow inclusion rate. In 
      intention-to-treat population (n = 186), the percentage of patients who reached 
      the composite endpoint was 25.5% (N = 25/98) in the 15-day group versus 35.2% 
      (N = 31/88) in the 8-day group (difference 9.7%, 90% confidence interval (CI) 
      -1.9%-21.2%). The percentage of recurrence of PA-VAP during the ICU stay was 9.2% 
      in the 15-day group versus 17% in the 8-day group. The two groups had similar 
      median days of mechanical ventilation, of ICU stay, number of extra pulmonary 
      infections and acquisition of multidrug-resistant (MDR) pathogens during ICU 
      stay. CONCLUSIONS: Our study failed to show the non-inferiority of a short 
      duration of antibiotics in the treatment of PA-VAP, compared to a long duration. 
      The short duration strategy may be associated to an increase of PA-VAP 
      recurrence. However, the lack of power limits the interpretation of this study.
CI  - (c) 2022. Springer-Verlag GmbH Germany, part of Springer Nature.
FAU - Bougle, Adrien
AU  - Bougle A
AUID- ORCID: 0000-0002-8990-4705
AD  - Department of Anesthesiology and Critical Care Medicine, Cardiology Institute, 
      Sorbonne University, GRC 29, AP-HP, Pitie-Salpetriere Hospital, 47-83 Boulevard 
      de l'Hopital, 75013, Paris, France. adrien.bougle@aphp.fr.
FAU - Tuffet, Sophie
AU  - Tuffet S
AD  - Department of Clinical Pharmacology-Clinical Research Platform, Sorbonne 
      University, AP-HP, Paris, France.
FAU - Federici, Laura
AU  - Federici L
AD  - Service de Reanimation Polyvalente, Centre Hospitalier Sud Francilien, Corbeil, 
      France.
FAU - Leone, Marc
AU  - Leone M
AD  - Service d'anesthesie et de reanimation, Hopital Nord, Assistance Publique 
      Hopitaux de Marseille, Aix Marseille Universite, Marseille, France.
FAU - Monsel, Antoine
AU  - Monsel A
AD  - Multidisciplinary Intensive Care Unit, Department of Anesthesioloy and Critical 
      Care, Sorbonne University, GRC 29, AP-HP, Pitie-Salpetriere Hospital, Paris, 
      France.
FAU - Dessalle, Thomas
AU  - Dessalle T
AD  - Department of Anesthesiology and Critical Care Medicine, Cardiology Institute, 
      Sorbonne University, GRC 29, AP-HP, Pitie-Salpetriere Hospital, 47-83 Boulevard 
      de l'Hopital, 75013, Paris, France.
FAU - Amour, Julien
AU  - Amour J
AD  - Department of Anesthesiology and Critical Care Medicine, Cardiology Institute, 
      Sorbonne University, GRC 29, AP-HP, Pitie-Salpetriere Hospital, 47-83 Boulevard 
      de l'Hopital, 75013, Paris, France.
FAU - Dahyot-Fizelier, Claire
AU  - Dahyot-Fizelier C
AD  - Department of Anaesthesia and Intensive Care, University Hospital of Poitiers, 
      Poitiers, France.
FAU - Barbier, Francois
AU  - Barbier F
AD  - Service de Medecine Intensive-Reanimation, Centre Hospitalier Regional d'Orleans, 
      14, avenue de l'Hopital, 45100, Orleans, France.
FAU - Luyt, Charles-Edouard
AU  - Luyt CE
AD  - Medical Intensive Care Unit, Pitie-Salpetriere Hospital, Sorbonne University, 
      AP-HP, Paris, France.
FAU - Langeron, Olivier
AU  - Langeron O
AD  - Multidisciplinary Intensive Care Unit, Department of Anesthesioloy and Critical 
      Care, Sorbonne University, GRC 29, AP-HP, Pitie-Salpetriere Hospital, Paris, 
      France.
FAU - Cholley, Bernard
AU  - Cholley B
AD  - Departement d'Anesthesie et Reanimation, Hopital Europeen Georges Pompidou, APHP, 
      Paris, France.
FAU - Pottecher, Julien
AU  - Pottecher J
AD  - Anaesthesiology, Critical Care and Perioperative Medicine, Strasbourg University 
      Hospital-EA3072, FMTS, Strasbourg, France.
FAU - Hissem, Tarik
AU  - Hissem T
AD  - General Intensive Care Unit, Sud-Essonne Hospital, Etampes, France.
FAU - Lefrant, Jean-Yves
AU  - Lefrant JY
AD  - Service des Reanimations, Pole Anesthesie Reanimation Douleur Urgence, CHU Nimes, 
      Nimes, France.
FAU - Veber, Benoit
AU  - Veber B
AD  - Department of Anesthesiology, Critical Care and Perioperative Medicine, Rouen 
      University Hospital, Rouen, France.
FAU - Legrand, Matthieu
AU  - Legrand M
AD  - Department of Anaesthesiology and Critical Care and Burn Unit, Groupe Hospitalier 
      Lariboisiere-Saint Louis, APHP, Paris, France.
FAU - Demoule, Alexandre
AU  - Demoule A
AD  - Service de Medecine Intensive Et Reanimation (Departement R3S), APHP-Sorbonne 
      Universite, Site Pitie-Salpetriere, Paris, France.
FAU - Kalfon, Pierre
AU  - Kalfon P
AD  - Service de Reanimation Polyvalente, Hopital Louis Pasteur, CH de Chartres, 
      Chartres, France.
FAU - Constantin, Jean-Michel
AU  - Constantin JM
AD  - Department of Perioperative Medicine, University Hospital of Clermont-Ferrand, 
      Clermont-Ferrand, France.
FAU - Rousseau, Alexandra
AU  - Rousseau A
AD  - Department of Clinical Pharmacology-Clinical Research Platform, Sorbonne 
      University, AP-HP, Paris, France.
FAU - Simon, Tabassome
AU  - Simon T
AD  - Department of Clinical Pharmacology-Clinical Research Platform, Sorbonne 
      University, AP-HP, Paris, France.
FAU - Foucrier, Arnaud
AU  - Foucrier A
AD  - Department of Anaesthesiology and Critical Care, Beaujon Hospital, DMU Parabol, 
      AP-HP Nord, Universite de Paris, Clichy, France.
CN  - iDIAPASON Trial Investigators
LA  - eng
GR  - P140923/Assistance Publique - Hopitaux de Paris/
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20220513
PL  - United States
TA  - Intensive Care Med
JT  - Intensive care medicine
JID - 7704851
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
CIN - Intensive Care Med. 2022 Jul;48(7):963-964. PMID: 35616656
CIN - Intensive Care Med. 2022 Jul;48(7):923-925. PMID: 35652919
CIN - Intensive Care Med. 2022 Jul;48(7):965-966. PMID: 35668221
EIN - Intensive Care Med. 2022 Jun 21;:. PMID: 35727349
MH  - Adult
MH  - Anti-Bacterial Agents/therapeutic use
MH  - Humans
MH  - Intensive Care Units
MH  - *Pneumonia, Ventilator-Associated/epidemiology
MH  - Pseudomonas aeruginosa
MH  - Respiration, Artificial
OTO - NOTNLM
OT  - Antibiotic therapy
OT  - Pseudomonas aeruginosa
OT  - Recurrence
OT  - Survival
OT  - Ventilator-associated pneumonia
FIR - Bougle, Adrien
IR  - Bougle A
FIR - Amour, Julien
IR  - Amour J
FIR - Dessalle, Thomas
IR  - Dessalle T
FIR - Bellenfant Zegdi, Florence
IR  - Bellenfant Zegdi F
FIR - Cholley, Bernard
IR  - Cholley B
FIR - Massot, Julien
IR  - Massot J
FIR - Constantin, Jean-Michel
IR  - Constantin JM
FIR - Demoule, Alexandre
IR  - Demoule A
FIR - Mayaux, Julien
IR  - Mayaux J
FIR - Dubee, Vincent
IR  - Dubee V
FIR - Dupont, Herve
IR  - Dupont H
FIR - Duranteau, Jacques
IR  - Duranteau J
FIR - Federici, Laura
IR  - Federici L
FIR - Foucrier, Arnaud
IR  - Foucrier A
FIR - Geeraerts, Thomas
IR  - Geeraerts T
FIR - Guichon, Celine
IR  - Guichon C
FIR - Kalfon, Pierre
IR  - Kalfon P
FIR - Kipnis, Eric
IR  - Kipnis E
FIR - Lasocki, Sigismond
IR  - Lasocki S
FIR - Lefrant, Jean-Yves
IR  - Lefrant JY
FIR - Legrand, Matthieu
IR  - Legrand M
FIR - Leone, Marc
IR  - Leone M
FIR - Lescot, Thomas
IR  - Lescot T
FIR - Levy, Bruno
IR  - Levy B
FIR - Cousson, Joel
IR  - Cousson J
FIR - Montravers, Philippe
IR  - Montravers P
FIR - Tanaka, Sebastien
IR  - Tanaka S
FIR - Novy, Emmanuel
IR  - Novy E
FIR - Ouattara, Alexandre
IR  - Ouattara A
FIR - Payen, Jean-Francois
IR  - Payen JF
FIR - Picard, Walter
IR  - Picard W
FIR - Poete, Pascale
IR  - Poete P
FIR - Pottecher, Julien
IR  - Pottecher J
FIR - Quesnel, Christophe
IR  - Quesnel C
FIR - Fartoukh, Muriel
IR  - Fartoukh M
FIR - Tesniere, Anoine
IR  - Tesniere A
FIR - Fromentin, Melanie
IR  - Fromentin M
FIR - Rouby, Jean-Jacques
IR  - Rouby JJ
FIR - Lu, Qin
IR  - Lu Q
FIR - Langeron, Olivier
IR  - Langeron O
FIR - Squara, Pierre
IR  - Squara P
FIR - Levesque, Eric
IR  - Levesque E
FIR - Mongardon, Nicolas
IR  - Mongardon N
FIR - Simon, Tabassome
IR  - Simon T
FIR - Berard, Laurence
IR  - Berard L
FIR - Cachanado, Marine
IR  - Cachanado M
FIR - Soussi, Nora
IR  - Soussi N
EDAT- 2022/05/14 06:00
MHDA- 2022/07/14 06:00
CRDT- 2022/05/13 14:34
PHST- 2022/01/08 00:00 [received]
PHST- 2022/03/22 00:00 [accepted]
PHST- 2022/05/14 06:00 [pubmed]
PHST- 2022/07/14 06:00 [medline]
PHST- 2022/05/13 14:34 [entrez]
AID - 10.1007/s00134-022-06690-5 [pii]
AID - 10.1007/s00134-022-06690-5 [doi]
PST - ppublish
SO  - Intensive Care Med. 2022 Jul;48(7):841-849. doi: 10.1007/s00134-022-06690-5. Epub 
      2022 May 13.