Extracorporeal membrane oxygenation (ECMO) is widely utilized worldwide, and many hospitals are considering employing antibiotics to prevent nosocomial infection in ECMO patients. On the other hand, antimicrobial prophylaxis for ECMO patients has yet to be proven effective. A study determines how effective prophylactic antibiotics are for ECMO patients. From July 1, 2010, to March 31, 2017, Researchers used the Japanese Diagnosis Procedure Combination database to conduct this retrospective cohort analysis. Using propensity score matching, we examined in-hospital mortality, nosocomial pneumonia, acute renal damage, and diarrhea between patients who received preventive antibiotics (prophylaxis group) and those who did not receive antibiotics (control group). Multivariable logistic regression models were fitted using a generalized estimating equation, stabilized inverse probability of treatment weighting, and instrumental variable analysis for in-hospital mortality and nosocomial pneumonia.
Researchers found 9,615 individuals who were eligible and divided them into two groups: prophylaxis (n=5,552) and control (n=4,063). They created 3,650 couples in the propensity score-matched analysis. In-hospital mortality (56.4% vs. 59.8%; risk difference, −3.7%; 95% confidence interval [CI], −6.0 to −1.3) and nosocomial pneumonia (12.9% vs. 15.3%; risk difference, −2.4%; 95% CI: −4.3 to −0.6) showed significant differences between the prophylaxis and control groups. When used during ECMO treatment, prophylactic antibiotics were linked to lower in-hospital mortality and a lower proportion of patients with nosocomial pneumonia. Future prospective research will be required to confirm these findings.
Reference:www.atsjournals.org/doi/full/10.1513/AnnalsATS.202008-974OC
