.jpg "Laura Blackburn, BCCCP, PharmD, FCCM photo")
Laura Blackburn, BCCCP, PharmD, FCCM
Clinical Pharmacy Manager
HCA Houston Healthcare Clear Lake
Kingwood
Disclosure information not submitted.
Hannah Poquiz, PharmD
PGY1 Pharmacy Resident
HCA Houston Healthcare Clear Lake, United States
Disclosure information not submitted.
Hannah Ehrenfeld, PharmD, BCPS
Clinical Pharmacy Specialist
HCA Houston Healthcare Clear Lake, United States
Disclosure information not submitted.
Hanhnhi Duong, PharmD, BCPS, BCCCP, BCCP
Clinical Pharmacy Specialist
HCA Houston Healthcare Clear Lake, United States
Disclosure information not submitted.
Title: Antibiotic Prophylaxis in Cardiac Arrest Patients Receiving Targeted Temperature Management
Introduction:
A study was conducted to evaluate the efficacy of antibiotic prophylaxis for early onset pneumonia in cardiac arrest patients who achieve return of spontaneous circulation (ROSC) and receive targeted temperature management (TTM).
Methods:
A single-center, retrospective review was conducted using data collected from electronic medical records and pharmacy surveillance system at a 532-bed community medical center in adult cardiac arrest patients admitted to a critical care unit after ROSC and initiated on TTM between January 1, 2018 to July 31, 2020. The primary outcome was the incidence of early onset pneumonia defined as pneumonia occurring within the first seven days after cardiac arrest. Secondary outcomes include length of ICU stay, length of hospital stay, ventilator days, mortality at day 28, and incidence of subsequent C. difficile and other infections.
Results:
A total of 155 patients were evaluated and included for statistical analysis. Of the patients included in the study, 136 patients (88%) received antibiotic prophylaxis. No statistical significance was seen between the study groups for the primary outcome (46 vs. 71%, P=0.2538). For secondary outcomes, median days for ICU stay, hospital stay and ventilator days were lower in patients who received antibiotic prophylaxis but did not reach statistical significance. Incidence of subsequent C. difficile and other infections occurred more frequently in the antibiotic prophylaxis group but did not reach statistical significance. Mortality at day 7 and day 28 were lower in the antibiotic prophylaxis group when compared to the no prophylaxis group but did not reach statistical significance.
Conclusion:
In cardiac arrest patients receiving TTM, antibiotic prophylaxis did not have a statistically significant impact on the prevention of early onset pneumonia or other clinically relevant outcomes supporting suggestions from the 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Further study and high-quality randomized control trials is warranted to assess risk versus benefit of prophylactic antibiotic therapy in this patient population.