Preventive Use of Antibiotics Cuts ICU Deaths

Dutch researchers admit more review is needed on potential antibiotic resistance

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WEDNESDAY, Dec. 31, 2008 (HealthDay News) -- Giving people antibiotics before they were admitted to a hospital intensive care unit led to a drop in patient deaths, a new Dutch study found.

The findings should settle a long-running debate on whether the use of antibiotics as a preventive measure for intensive care patients offsets the risk of possible antibiotic resistance, said study author Dr. Anne Marie de Smet, an anesthesiologist-intensivist at University Medical Center Utrecht.

The study, published in the Jan. 1 issue of the New England Journal of Medicine, included nearly 6,000 patients treated at 13 hospitals in the Netherlands between 2004 and 2006.

For the study, the researchers compared the use of two types of antibiotic treatments to standard ICU care. They divided the patients into three groups. The first group received an oral antibiotic paste four times a day. The second group received antibiotics through a gastric tube in the intestinal tract and by intravenous drip, as well as the antibiotic paste. The third group received standard ICU care.

All the patients were expected to be on a ventilator for at least two days and/or to be admitted to the ICU for at least three days.

After four weeks, the preventive use of antibiotics reduced the number of deaths by 3.5 percent in the group receiving oral antibiotic paste as well as antibiotics in the intestinal tract and by intravenous drip, and by 2.9 percent in the oral antibiotic paste group. The difference between the two groups treated with antibiotics was not significant, the researchers said.

What's more, the number of antibiotic-resistant bacteria did not increase in patients receiving antibiotic treatment, the researchers said.

"I believe we should revise the antibiotic policy for the ICU," de Smet said in a news release. "Because the study was conducted in 13 Dutch hospitals, the conclusions can be implemented throughout the country. We have seen that using antibiotics clearly results in a reduction in the number of deaths, and ICUs should make use of this knowledge."

The researchers acknowledged that the study was too short to determine how antibiotic resistance might develop in the long term, adding this will require additional research.

More information

To learn more about antibiotics, visit the U.S. National Library of Medicine.

SOURCE: University Medical Center Utrecht, the Netherlands, news release, Dec. 31, 2008

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