Empirical antibiotic therapy for spontaneous intracerebral hemorrhage-associated pneumonia: an ICU-based single-centered retrospective cohort study
Abstract
Pneumonia is a common and severe complication following spontaneous intracerebral hemorrhage (SICH) and is associated with significantly worse clinical outcomes. However, there remains insufficient evidence supporting empirical antibiotic regimens for SICH-associated pneumonia (SICHAP). To evaluate the clinical efficacy of different empirical antibiotic regimens in patients with SICHAP and to provide evidence for optimizing initial antimicrobial strategies. This single-center retrospective cohort study enrolled adult patients with SICH who developed pneumonia within 7 days of onset between July and December 2024. Patients were stratified according to their initial empirical antibiotic regimen: cefazolin (CFZ), ceftriaxone (CRO), cefoperazone-sulbactam (CFP-SUL), or piperacillin-tazobactam (PIP-TAZ). The primary outcome was the clinical efficacy rate at 72 h. The secondary outcomes included the SICHAP treatment failure rate, in-hospital mortality, length of stay, duration of mechanical ventilation, and duration of antibiotic therapy. Treatment appropriateness was assessed on the basis of sputum culture and antimicrobial susceptibility testing. A total of 85 patients (mean age 54.2 ± 13.5 years, 63.5% male) were enrolled, with 90.6% presenting with early SICHAP. The 72-hour efficacy rate in the CFP-SUL group (73.3%) was significantly greater than that in the CFZ group (25.0%), CRO group (54.5%), and PIP-TAZ group (58.8%) (p = 0.022). The overall SICHAP treatment failure rate…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 85 participants or records.
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