Inadequate Empirical Antibiotic Therapy in VAP: Risk Factors and Outcomes

journals.lww.com April 22, 2025

Ventilator-associated pneumonia (VAP) caused by MDR pathogens were highly likely to receive inadequate empirical antibiotic therapy. The mortality rate and intubation duration were significantly longer in inadequately treated VAP as compared to adequately treated VAP.

The risk factors studied in this meta-analysis were isolation of multi-drug resistant (MDR) bacteria, prior use of antibiotics, admission in surgical units, polymicrobial infection, and late-onset VAP.

Isolation of MDR bacteria from the patient significantly increased the risk of inadequate empirical antibiotic treatment (OR = 2.50, 95% C.I. = 1.57-3.97, P < 0.016). Prior use of antibiotics, admission in surgical units, polymicrobial infection, and late-onset VAP were not associated with the inadequate treatment.