Prospective Study of Colonization, Infection and Mortality Rates during Conventional Therapy
During August 1986-January 1987 we evaluated all ICU patients who were expected to be ventilated for more than 4 days, excluding any with pneumonia on admission to the ICU. The 83 patients studied included cases of trauma, abdominal and thoracic surgery, peritonitis, cardiopulmonary insufficiency and vascular diseases; patients were mechanically ventilated for 8–14 days. Gastrointestinal surgical patients were given systemic prophylaxis with mezlocillin (3 × 4 g) and metronidazole (2 × 0.5 g) for 24 h; trauma patients with open fractures were given prophylactic cefazolin (3 × 2 g) and netilmicin (3 × 150 mg) for 48 h. Diffuse peritonitis was treated with mezlocillin (3 × 4 g), metronidazole (2 × 0.5 g) and netilmicin (3 × 150 mg). Antibiotic therapy for respiratory tract infections was based on susceptibility tests. Pharyngeal and rectal swabs, tracheal aspirates, urine cultures, and — if necessary — swabs from wounds and drains were taken immediately after admission to the ICU and routinely three times a week thereafter. Only pirenzepine was used for stress ulcer prophylaxis; antacids and H2-blockers were not used.