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February 18, 2004

Eight Days vs 15 Days of Antibiotics for Ventilator-Associated Pneumonia

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(7):820. doi:10.1001/jama.291.7.820-a

To the Editor: Dr Chastre and colleagues1 reported that an 8-day course of antibiotic therapy for ventilator-associated pneumonia (VAP) was equally effective as a 15-day course. I have some concerns about the design of this study. First, only 35% of the eligible patients were recruited after day 3, which could have biased the results. Only patients with an Acute Physiology and Chronic Health Evaluation score of less than 65 and no extrapulmonary infections were enrolled; the use of such strict exclusion criteria could have been responsible for the lack of difference between the longer and shorter regimen. It is possible that the shorter antibiotic regimen would not be equally effective in patients who are more critically ill.