tailieunhanh - Báo cáo y học: "Medical resource utilization among patients with ventilator-associated pneumonia: pooled analysis of randomized studies of doripenem versus comparators"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Medical resource utilization among patients with ventilator-associated pneumonia: pooled analysis of randomized studies of doripenem versus comparators. | Kollef et al. Critical Care 2010 14 R84 http content 14 3 R84 c CRITICAL CARE RESEARCH Open Access Medical resource utilization among patients with ventilator-associated pneumonia pooled analysis of randomized studies of doripenem versus comparators Marin H Kollef 1 Dilip Nathwani2 Sanjay Merchant3 Christopher Gast4 5 Alvaro Quintana6 and Nzeera Ketter7 Abstract Introduction Ventilator-associated pneumonia VAP is associated with increased medical resource utilization but few randomized studies have been conducted to evaluate the effect of initial antibiotic therapy. To assess medical resource utilization in patients with VAP we conducted a pooled analysis of two prospective randomized open-label multicenter phase III studies which also showed that doripenem was clinically noninferior to comparators. Methods We assessed durations of mechanical ventilation intensive care unit ICU stay and hospitalization in patients with VAP who received at least 1 dose of doripenem or a comparator in the phase III studies. Comparators were piperacillin tazobactam study 1 and imipenem study 2 . We analyzed between-group differences in medical resource utilization endpoints by comparison of Kaplan-Meier curves with generalized Wilcoxon test and in microbiologic eradication rates by two-sided Fisher s exact test. Results 625 patients with VAP were evaluated and received at least 1 dose of doripenem n 312 or a comparator n 313 . Median durations of mechanical ventilation 7 versus 10 days P and hospitalization 22 versus 26 days P were shorter for doripenem than comparators corresponding ICU stays were 12 and 13 days P . Allcause overall mortality rates were similar 51 312 16 versus 47 313 15 P . MIC90 values against Pseudomonas aeruginosa for doripenem versus imipenem were 4 versus 16 pg mL in study 2. P aeruginosa was eradicated from 16 24 67 doripenem recipients and 10 24 42 comparator recipients P . In patients with P aeruginosa at baseline .