ABSTRACT It is not clear what is the appropriate timing to follow-up patients with ventilator-associated pneumonia (VAP) and Clinical Pulmonary Infe- ction Score >6 between days 3-5 of an appro- priate antibiotic treatment. We studied 122 patients with Pseudomonas aeruginosa VAP. A follow-up respiratory sample was collected on days three or five ( “day-three” and “day-five” group ) and treatment was modified 48h later. Molecular typing identified super-infections or persistence. For serial data another respiratory sample was collected, on day three from the “day-five” group and on day five from the “day-three” group. Sixty patients, in the “day- three” group compared to 62 in the “day-five” group, had reduced fourteen-day mortality ( 18.3% and 38.7%; p=0.01 ) and fewer days in intensive care unit (17.2 ± 4.3 compared to 27.3 ± 4.7, p<0.05 ). Eighteen patients of the “day- five” group were diagnosed with super-infec tion and 22 with persistence on day five, of whom 14 and 19 had been having these patterns since day three. For patients with Pseudomonas aeruginosa VAP and Clinical Pulmonary Infe- ction Score >6, improved fourteen-day mortality and shorter duration of stay in health-care facilities were observed with earlier follow-up.
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