The American surgeon
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The American surgeon · Dec 2000
Effects of empiric antibiotic administration for suspected pneumonia on subsequent opportunistic pulmonary infections.
Optimal guidelines for empiric antibiotic (EAB) therapy in cases of suspected post-traumatic ventilator-associated pneumonia (VAP) are not well defined. EAB administration is thought to increase the incidence of opportunistic organisms; however, culture-directed (as opposed to empiric) treatment may delay antibiotic administration with possible adverse consequences. Our goal was to examine the impact of EAB administration on the incidence of subsequent VAP and opportunistic organisms in a series of critically injured patients with sepsis syndrome. ⋯ Twenty-one of the 23 opportunistic VAPs at subsequent FOBs had received EAB before the first FOB compared with four of seven nonopportunistic organisms (P = 0.06). Administration of EAB does not impact the incidence of subsequent VAP. However, EAB may be related to the development of subsequent opportunistic pulmonary infections.