July 2018 Vol.6 No.6

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Original Research Article

Ventilator-associated pneumonia (VAP) prevention using clarithromycin among ICU-hospitalized patients

Mirjalili Mohammadreza, Rahimian Masoud and Jaafarinia Asma^*

Department of Internal Medicine, Shahid Sadoughi University of Medical Sciences

*Corresponding Author’s E-mail: m_rezaei@sbmu.ac.ir

Accepted February 21, 2018

Abstract

Ventilator-Associated Pneumonia (VAP) is a nosocomial infection which may be prevented using interventions such as Clarithromycin (Clrtm) prophylaxis. Then, the aim is to do a clinical trial on the prophylactic effect of this macrolide drug on VAP. Sixteen Intensive Care Unit (ICU) hospitalized patients, randomly were categorized into Clrtm and placebo groups. Twenty-seven patients were received 500 mg Clrtm (intervention group) and 33 were received the placebo (placebo group), both bi-daily for 5 days. We analyzed the occurrence of VAP, mortality rate, duration of mechanical ventilation, length of ICU staying and organ dysfunction via comparison of two groups with statistical methods where the confidence interval was 95%. The average duration of ICU staying was 13.26 days in Clrtm-treated and 8.12 days in placebo-treated groups. APACHE scores were significant between two studied groups only for day 10 and not for days 1 and 5. Ventilator associated pneumonia was confirmed with microbial culture and was also meaningful among survived patients; Clrtm-treated group had lower positive cultures than placebo (p=0.031). Sixteen (59.25%) Clrtm and 23 (69.69%) placebo patients were expired from whom 11 (40.75%) were in Clrtm group and 10 (30.31%) in placebo group which was not statistically significant (p=0.399). Other investigated variables were not statistically different between two groups. Clarithromycin was effective in the reducing the rate and complications of VAP; however, some investigated variables had not significant results probably due to the low sample size of study which was obligatory due to the entity of the clinical trial. Anyway, it is concluded that prophylactic administration of Clrtm, could decrease the length of ICU-staying and VAP.

Keywords: Clarithromycin, ventilator associated pneumonia (VAP), organ dysfunction, intensive care unit, clinical trial