3. Compared to patients with PSPA-VAP, patients with PRPA-VAP were Crizotinib order significantly more likely to have received broad-spectrum antimicrobials during their admission in the ICU (77.1% (54 of 70 patients) vs. 60.1% (92 of 153 patients); P = 0.03). Before VAP diagnosis, patients with PRPA-VAP were more likely to have received tazobactam therapy (18.6% (13 of 70 patients) vs. 9.2% (14 of 153 patients); P = 0.01), and to have received ureidopenicillins or carboxypenicillins therapy (31.4% (22 of 70 patients) vs. 13.1% (20 of 153 patients); P = 0.0004). Differences in the use of fluoroquinolones therapy did not reach statistical significance (24.3% in PRPA group (7 of 70 patients) vs. 13.1% in PSPA group (20 of 153 patients); P = 0.058).

Table 3Antimicrobials received in the ICU within the seven days prior to VAP onsetPercentage of antibiotic-free days was different between the two groups for tazobactam, and ureidopenicillins-carboxypenicillins. Compared with patients with PRPA-VAP, patients with PSPA-VAP had more tazobactam-free days (P = 0.019), and less ureidopenicillins-carboxypenicillins-free days (P = 0.007).Adequate antibiotic therapy was started within 24 h after the diagnosis of VAP for 36 patients (51.4%) in the PRPA-VAP group, versus 117 patients (76.5%) in the PSPA-VAP group (P = 0.001). Adequate antibiotic therapy was started at least two days after PA VAP diagnosis for 25 patients (35.7%) in the PRPA-VAP group, versus for 26 patients (17%) in the PSPA-VAP group (P = 0.007). Use of bi- or tri-antimicrobial-therapy was similar between groups.

Antibiotic therapy before ICU discharge was not adequate for 9 patients (12.9%) in the PRPA-VAP group, versus 10 patients (6.5%) in the PSPA-VAP group (P = 0.054).The rate of recurrence was not influenced by resistance (PSPA-VAP 28 (18.3%) vs PRPA-VAP 11 (15.7%), P = 0.83).Compared with patients with PSPA-VAP, PRPA-VAP patients had similar lengths of ICU stay prior to VAP (11 days (range, 6 to 18 days) vs. 9 days (range, 6 to 17 days); P = 0.53). PRPA-VAP and PSPA-VAP were associated with similar crude ICU mortality (38% (25 of 70 patients) vs. 41% (62 of 153 patients); P = 0.56) as well as in hospital mortality (43% (30 of 70 patients) vs. 44% (68 of 153 patients); P = 0.85).Risk factors for deathRisk factors for ICU death are listed in Table Table1.1.

Risk factors found for ICU death at admission were: age, at least one chronic illness, admission for cardiac illness or septic shock, Simplified Acute Physiology Score version II (SAPS II), organ dysfunction scores (LOD, SOFA). Two days before PA-VAP, risk factors for ICU death were: GSK-3 treatment with vasopressors, treatment with steroids, SAPS II, and organ dysfunction scores (LOD, SOFA).Resistance to Ureido/carboxypenicillin was not a risk factor for ICU death.