{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T04:47:32Z","timestamp":1764996452103,"version":"3.46.0"},"reference-count":17,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T00:00:00Z","timestamp":1712793600000},"content-version":"unspecified","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Post Graduate Thesis Fund","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,3,26]]},"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To estimate all-cause mortality in ventilator-associated pneumonia (VAP) and determine whether antibiotic duration beyond 8\u2009days is associated with reduction in all-cause mortality in patients admitted with VAP in the intensive care unit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A prospective cohort study of patients diagnosed with VAP based on the National Healthcare Safety Network definition and clinical criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Single tertiary care hospital in Southern India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>100 consecutive adult patients diagnosed with VAP were followed up for 28 days postdiagnosis or until discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>\n                      The incidence of mortality at 28 days postdiagnosis was measured. Tests for association and predictors of mortality were determined using \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      test and multivariate Cox regression analysis. Secondary outcomes included baseline clinical parameters such as age, underlying comorbidities as well as measuring total length of stay, number of ventilator-free days and antibiotic-free days.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The overall case fatality rate due to VAP was 46%. There was no statistically significant difference in mortality rates between those receiving shorter antibiotic duration (5\u20138 days) and those on longer therapy. Among those who survived until day 9, the observed risk difference was 15.1% between both groups, with an HR of 1.057 (95% CI 0.26 to 4.28). In 70.4% of isolates, non-fermenting Gram-negative bacilli were identified, of which the most common pathogen isolated was\n                      <jats:italic>Acinetobacter baumannii<\/jats:italic>\n                      (62%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this hospital-based cohort study, there is insufficient evidence to suggest that prolonging antibiotic duration beyond 8 days in patients with VAP improves survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-077428","type":"journal-article","created":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T13:25:45Z","timestamp":1712841945000},"page":"e077428","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Association of antibiotic duration and all-cause mortality in a prospective study of patients with ventilator-associated pneumonia in a tertiary-level critical care unit in Southern India"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8827-4561","authenticated-orcid":false,"given":"Nivin Daniel","family":"Stanley","sequence":"first","affiliation":[{"name":"Department of Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7045-2457","authenticated-orcid":false,"given":"Jonathan Arul","family":"Jeevan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5764-1373","authenticated-orcid":false,"given":"Bijesh","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8615-5753","authenticated-orcid":false,"given":"Karthik","family":"Gunasekaran","sequence":"additional","affiliation":[{"name":"Department of Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6977-1183","authenticated-orcid":false,"given":"Kishore","family":"Pichamuthu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9117-1996","authenticated-orcid":false,"given":"Vignesh Kumar","family":"Chandiraseharan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9443-0022","authenticated-orcid":false,"given":"Sowmya","family":"Sathyendra","sequence":"additional","affiliation":[{"name":"Department of Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel George","family":"Hansdak","sequence":"additional","affiliation":[{"name":"Department of Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8453-6205","authenticated-orcid":false,"given":"Ramya","family":"Iyyadurai","sequence":"additional","affiliation":[{"name":"Department of Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, 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