Efficacy and Safety of Systemic Prophylactic Antibacterials in Mechanically Ventilated Patients: Systematic Review and Meta-Analysis
Abstract
OBJECTIVES
Previous studies have shown that selective decontamination of the digestive tract can reduce the incidence and mortality of ventilator-associated pneumonia (VAP) in mechanically ventilated patients. However, the prophylactic role of IV antibacterials, one of its essential components, remains unclear. Therefore, this study aims to evaluate the efficacy and safety of systemic prophylactic use of antibacterials in mechanically ventilated patients.
DATA SOURCES
We systematically searched PubMed, Embase, and The Cochrane Library from inception to November 30, 2025.
STUDY SELECTION
Randomized controlled trials (RCTs) evaluating prophylactic use of systemic antibacterials in mechanically ventilated patients in the ICUs were included.
DATA EXTRACTION
Two researchers independently conducted literature screening, data extraction, and quality assessment. Meta-analysis was performed using RevMan 5.4, and the quality of the evidence was evaluated using the recommended Grading of Recommendations, Assessment, Development, and Evaluation method.
DATA SYNTHESIS
Eleven RCTs with 5562 patients were included. Meta-analysis results showed that the systemic prophylactic use of antibacterials probably reduces the incidence of VAP (relative risk [RR], 0.65; 95% CI, 0.55-0.77; moderate certainty) and the incidence of early VAP (RR, 0.52; 95% CI, 0.41-0.66; moderate certainty), but probably does not reduce in-hospital mortality (RR, 0.85; 95% CI, 0.68-1.06; moderate certainty) or duration…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 5,562 participants or records.
Read the paper
Related studies
- Penicillins for Treatment of Pneumococcal Pneumonia: Does In Vitro Resistance Really Matter?
- Thiophenes—Naturally Occurring Plant Metabolites: Biological Activities and In Silico Evaluation of Their Potential as Cathepsin D Inhibitors
- Inhalable Mannosylated Rifampicin–Curcumin Co-Loaded Nanomicelles with Enhanced In Vitro Antimicrobial Efficacy for an Optimized Pulmonary Tuberculosis Therapy
- Development and validation of microbial bioassay for quantification of Levofloxacin in pharmaceutical preparations
- GC-MS Analysis and Biomedical Therapy of Oil from n-Hexane Fraction of Scutellaria edelbergii Rech. f.: In Vitro, In Vivo, and In Silico Approach
- Propranolol, chlorpromazine and diclofenac restore susceptibility of extensively drug-resistant (XDR)-Acinetobacter baumannii to fluoroquinolones
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.