PAST_IS…

Study Purpose

To estimate the prevalence of pneumonia after tracheotomy in patients with head and neck cancer, and to evaluate the effect of prophylactic antibiotics

Intervention Characteristics/Basic Study Process

Data on patients who underwent tracheotomy were obtained from health records, and patients were grouped according to whether they had been given prophylactic antibiotics. In all cases, tracheotomy was the primary operation. The comparison of ventilator-associated pneumonia was analyzed.

Sample Characteristics

N = 88
MEAN AGE = 68.3 years (SD = 9.9)
MALES: 69%, FEMALES: 31%
KEY DISEASE CHARACTERISTICS: All had head and neck cancer, and 71% had prior radiation therapy.
OTHER KEY SAMPLE CHARACTERISTICS: Of the patients, 88% had underwent a because of stridor. The median time from radiation to the procedure was 160 days.

Setting

SITE: Single site
SETTING TYPE: Inpatient
LOCATION: Denmark

Phase of Care and Clinical Applications

PHASE OF CARE: Transition phase after active treatment

Study Design

Retrospective

Measurement Instruments/Methods

Pneumonia was defined as the clinical suspicion of pneumonia or the postoperative administration of antibiotics.

Results

More patients who did not receive prophylaxis received antibiotics postoperatively (p = 0.04). The hospital stays of those given prophylactic antibiotics were seven days shorter (p < 0.01).

Conclusions

Prophylactic antibiotic administration for patients undergoing tracheotomy may reduce the risk of postprocedure ventilator-associated pneumonia.

Limitations

Small sample (< 100)
Risk of bias (no blinding)
Risk of bias (no random assignment)
Measurement/methods not well described
Measurement validity/reliability questionable
No standard and objective measure of pneumonia

Nursing Implications

Prophylactic antibiotic use in patients undergoing surgical procedures has been shown to reduce postoperative infections. The findings from this study add to that body of evidence, suggesting that this approach prior to tracheostomy provides a similar benefit in preventing ventilator-associated pneumonia.