Table 2.
Summary of baseline characteristics in included studies.
| Study | Country | Study design | Sample demographics | Reason for ventilation | Previous antibiotic use | Mean APACHE II score | Comorbidities | Diagnostic criteria for VAP |
|---|---|---|---|---|---|---|---|---|
| Tincu et al[17] | Romania | RCT | n = 188; mean age, 39.5 years; 64.5% male | 47.4% respiratory failure, 19.3% CV failure, 33% CNS disorders | NR | NR | Intervention: 13% Control: 14% |
CDC diagnostic criteria 2021 |
| Damas et al[18] | Belgium | Multicenter, randomized, controlled, double-blind, prospective study | n = 323; median age, 67.6 years; 55.5% male | 33% respiratory, 19.7% neuro, 16.8% cardiac, and 30.5% other cases | Intervention: 70.8% Control: 78.1% |
NR | Median Charlson score of 2 for both intervention and control | New infiltrate on chest X-ray + fever (>38.3 °C) or hypothermia (<36 °C), leukocytosis (>11.109 WBC/L) or leukopenia (<4.109 WBC/L), plus at least one of purulent secretions, FiO2 increase ≥0.2 or PEEP increase ≥3-cm H2O for 2 days, and culture >106 CFU/mL from endotracheal specimen or >104 CFU/mL from BAL, after 48 h of ventilation. |
| Mahmodiyeh et al[19] | Iran | Single-blind clinical trial study | n = 108; mean age, 45.4 years | NR | NR | NR | Intervention: 19.6% Control: 20.3% |
Fever, purulent secretion, leukocytosis, and decreased oxygen saturation. |
| Zampieri et al[20] | Brazil | Pilot single-blinded RCT | n = 108; mean age, 57 years; 54.1% male | 72.7% medical and 27.3% surgical cases | Intervention: 66.7% Control: 72.7% |
NR | Intervention: 20.3% Control: 22.9% |
New/progressive radiographic consolidation or infiltrate, plus at least 2 of Temp >38°C, WBC ≥12,000/mm³ or <4000/mm³, and purulent secretions. |
| Mahmoodpoor et al[22] | Iran | RCT | n = 90; mean age, 60 years; 67% male | 51.2% medical, 27.3% surgical, and 21.1% trauma cases | NR | Intervention: 22 (19–26) Control: 21 (20–24) |
NR | Patients on mechanical ventilation >48 h and by using clinical pulmonary infection score.[24] |
| Afessa[23] | North America | Retrospective cohort analysis of 1 previous trial[21] | n = 93; mean age, 61.6 years; 66.4% male | NR | NR | Intervention: 18.4 ± 5.9 Control: 20.3 ± 7.0 |
NR | Micro-organisms present at a concentration of ≥104 CFU/mL in BAL fluid |
| Kollef et al[21] | North America | Prospective, randomized, single-blind, controlled study | n = 1508; mean age, 61.5 years; 58% male | 18.9% medical, 30.2% surgical, 34.9% trauma cases, 16% other cases | NR | Intervention: 21.5 (7.5) Coated: 21.6 (7.5) |
NR | BAL fluid culture ≥104 CFU/mL in patients intubated ≥24 h |
APACHE = Acute Physiology and Chronic Health Evaluation, BAL = bronchoalveolar lavage, CDC = Centers for Disease Control and Prevention, CNS = central nervous system, CV = cardiovascular, FiO2 = fraction of inspired oxygen, NR = not reported, PEEP = positive end-expiratory pressure, RCT = randomized controlled trial, VAP = ventilator-associated pneumonia, WBC = white blood cell count.