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ORIGINAL ARTICLE
Year : 2018  |  Volume : 2  |  Issue : 1  |  Page : 1-7

Comparative study between usage of tazocin/vancomycin versus tazocin/linezolide in treatment of traumatized contused lung


Department of Anesthesia and ICU, Faculty of Medicine, Ain Shams University, Cairo, Egypt; Consultant Intensivist in Intensive Care Depatement, King Abdel Aziz Specialist Hospital, Taif, KSA

Correspondence Address:
Mohamed Gaber Ibrahium Mostafa Allam
Department of Anesthesia and ICU, Faculty of Medicine, Ain Shams University, Cairo; King Abdel Aziz Specialist Hospital, Taif

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sccj.sccj_10_18

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Introduction: Ventilator-associated pneumonia (VAP) is subtype of healthcare acquired pneumonia. With high mortality rate (46%), especially in contused lungs due to trauma. Antibiotics are important in treatment of VAP. Aim of Work: The aim is to evaluate and compare the effect of the use of tazocin (piperacillin + tazobactam)/vancomycin combination versus the use of tazocin/linezolid in the treatment of VAP and weaning from the ventilator in traumatized lungs in patients with severe chest trauma complicated with VAP. Patients and Methods: Prospective double-blind study conducted on 200 patients from King Abdul-Aziz Specialized Hospital. Patients were allocated into two groups as follows: Group A included 100 patients who received piperacillin-tazobactam with vancomycin with the five points of bundle of VAP prevention while Group B included another 100 patients who received piperacillin-tazobactam but with linezolid and with the five points of bundle of VAP prevention. In this study, diagnosis of lung contusion was made by computerized axial tomography of the chest while VAP was diagnosed by modified clinical pulmonary infection score (CPIS). Any patient who had score of 6 or more was considered to have VAP. Results: 15, 38, and 46 patients in Group A showing controlled tracheal secretion, respectively, in three studied period compared to 28, 75, and 83 in Group B, less parenchymatous lung infiltration in the chest X-ray 12, 40, and 48 patients in Group A compared to 24, 88, and 91 patients in Group B, improvement of the hypoxic index 48, 76, and 85 patients in Group A compared to 66, 90, and 98 patients in B, normalization of temperature 16, 36, and 54 patients in Group A while 40, 76, and 90 patients in B and reduction of total leukocytic count 18, 35, and 57 patients in Group A while 38,70, and 87 patients in Group B, there was 15 out of 98 patients in Group A not weaned while only 5 out of 100 patients in Group B cases failed to be weaned from mechanical ventilation within the studied period (2 weeks). Conclusion: The use of tazocin/linezolid provided a rapid response in treatment and less morbidity by shortening the duration of ventilation than tazocin/vancomycin in VAP that occurred in traumatized lungs.


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