Respiratory tract infection (PID) is one of the leading causes of death in the intensive care unit and the intensive care unit (ICU). Thus, the incidence of pneumonia associated with ventilator in these services varies from 7% to 40%, and the mortality due to this pathology reaches 50%.

The purpose of this study was A. Liberati et al. A systematic review was an evaluation of the efficacy of antibiotic prophylaxis of PDIs, as well as its effect on mortality in adult ICU patients. When searching for data, the Cochrane Central Register of Controlled Clinical Trials (CENTRAL, number 3, 2003), the MEDLINE database (for the period from January 1966 to September 2003) and EMBASE (for the period from January 1990 to September 2003) have been used. ), as well as data presented at scientific conferences and links to articles on relevant subjects from January 1984 to December 2002.

The review included the results of 36 randomized trials in which a total of 6,922 patients participated. Studies differed in the antibiotic used for prophylaxis, the characteristics of the patients, the degree of risk of developing respiratory infections and the mortality rate in the control groups.

In 17 studies (4295 patients), who evaluated the effectiveness of the combination of local and systemic antibiotic therapy, a significant decrease was shown as the incidence of PDI (odds ratio (OR) 0.35, interval of confidence (95% CI 0.29-0, 41) and mortality (OR 0.78, 95% CI 0.68-0.89) in the group of patients receiving treatment compared to the control group. According to the results of the analysis, on average, 5 patients need therapy to prevent the development of an infection and 21 patients to prevent death.

In 17 studies (2,664 patients) who assessed local antibiotic therapy (or a combination of local and systemic use versus systemic use), there was a significant decrease in the incidence of PDI (OR 0.52 , 95% CI 0.43-0.63), but not mortality (OR 0.97, 95% CI 0.81-1.16) in the group of patients receiving treatment compared to the control group.

Thus, combined antibiotic prophylaxis leads to a decrease in the incidence of respiratory infections and general mortality in adult ICU patients. The use of exclusively local antibiotic prophylaxis is insufficient, as it does not affect mortality. According to studies conducted in recent years, the risk of developing resistance as a negative consequence of antibiotic prophylaxis is minimal in this situation.