Post-Arrest Prophylactic Antibiotics?

• Pneumonia is the most common infective complication in post-cardiac arrest patients. It may develop in up to 60% of patients and is associated with an increased ICU length of stay.
• Given the challenges in diagnosing pneumonia in the post-cardiac arrest patient, many clinicians consider prophylactic antibiotic administration.
• A recent systematic review and meta-analysis sought to evaluate the effect of early antibiotic use on survival and survival with good neurologic outcome in adult patients resuscitated from cardiac arrest. Key study results include:
  • 11 studies (3 RCTs, 8 observational trials)
  • 6149 patients
  • No change in overall survival or survival with good neurologic outcome
• Take Home Point: Current data does not support the prophylactic administration of antibiotics to adults resuscitated from cardiac arrest.

References

Couper K, et al. Prophylactic antibiotic use following cardiac arrest: a systematic review and meta-analysis. Resuscitation. 2019; epub ahead of print.