January 1, 2009

Antibiotic Use Before Infections Prevent ICU Deaths

A major Dutch study published on Wednesday showed that giving antibiotics to patients in intensive care units increases their chances of survival.

The researchers said the benefits of administering antibiotics right away "” even before an infection develops "” outweigh the risks that people will develop resistance to them.

Anne Marie de Smet, a researcher at University Medical Center Utrecht, said using antibiotics clearly results in a reduction in the number of deaths.

"Intensive care units should make use of this knowledge," she said in a statement.

With the rise of superbugs such as methicillin-resistant Staphyloccus aureus, or MRSA, drug-resistant bacteria are a growing problem in hospitals worldwide. Such infections kill about 19,000 people a year in the United States, while more than 4,000 a year in Britain are infected.

Hospital-acquired infections are a major cause of death and disability worldwide, according to the World Health Organization.

Experts have been saying for years that poor hospital practices spread dangerous bacteria, but at the same time, doctors are told to cut back on using antibiotics to prevent the rise of resistant "superbugs."

Such infections can lead to life-threatening and disfiguring infections that can kill within days and can often only be treated with expensive, intravenous antibiotics. The risk of infection increases the longer people remain in the hospital.

During the study, a team of researchers compared the effect of two kinds of antibiotic treatments with the standard ICU care. De Smet and colleagues looked at 6,000 men and women who stayed in intensive care units for at least two days at 13 hospitals in the Netherlands to compare the effects of different antibiotic treatments.

The researchers found that volunteers who received oral antibiotics right away were 11 percent less likely to die, and those given oral and intravenous combinations right away were 13 percent less likely to die than people who did not get the drugs.

They also noted that the number of antibiotic-resistant bacterial infections did not increase among the people on the drugs.

Each year in the Netherlands, more than 18,000 patients are hospitalized in ICUs for more than three days.

"I believe we should revise the antibiotic policy for the ICU," said De Smet.

"Because the study was conducted in thirteen 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 tracked deaths 28 days after treatment began, so the next step is looking to see how resistance may develop in the long term.


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