Photo Credit: Tamer Soliman

The following is a summary of “Antibiotics versus Non-Antibiotic in the treatment of Aspiration Pneumonia: analysis of the MIMIC-IV database,” published in the December 2024 issue of Pulmonology by Zhang et al. 

Aspiration pneumonia (AP) is a frequent complication in the intensive care unit (ICU) linked with high morbidity and mortality, impacting patient outcomes, while the prognostic impact of antibiotic therapy for AP remains unclear.  

Researchers conducted a retrospective study to investigate the relationship between antibiotic use and in-hospital mortality in patients with AP, analyze the effects of different antibiotic regimens on prognosis, and understand pathogen distribution and drug resistance to guide rational medication use in clinical practice.  

They extracted clinical data of patients with AP from the MIMIC-IV database. Statistical analyses included multivariate logistic regression, propensity score matching (PSM), and inverse probability weighting (IPW) based on propensity scores to ensure the results’ robustness. Additionally, the characteristics of medications used by patients with AP were summarized using statistical graphs and tables.  

The results showed 4,132 patients with AP were included. In-hospital mortality was significantly lower in the antibiotic group compared to the non-antibiotic group (odds ratio [OR] = 0.44, 95% CI 0.27–0.71, P = 0.001). Among patients using mechanical ventilation (MV), antibiotics significantly reduced in-hospital mortality (OR = 0.30, 95% CI 0.15–0.57, P < 0.001). Vancomycin and cephalosporins were the most prescribed antibiotics, with vancomycin combined with piperacillin-tazobactam used in 396 cases. The highest survival rate (97.6%) was observed in patients treated with levofloxacin and metronidazole. Additionally, vancomycin and piperacillin-tazobactam showed significant differences in inflammation-related features compared to patients not receiving the medications.  

Investigators concluded the antibiotic use was closely linked to lower in-hospital mortality in ICU patients with AP, and understanding antibiotic use, pathogen composition, and drug resistance rates could aid in disease prevention and infection control. 

Source: bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-024-03441-8