Discussion
extra-pulmonary infections, infections, PA-VAP
RECURRENCE, INFECTIONS
In this study nested in a prospective randomized controlled trial on the duration of antibiotic therapy for PA-VAP, we did not show any difference between a combination of antibiotics and a monotherapy for definitive antibiotic therapy in terms of mortality rate at day 90, recurrence of VAP, number of extra-pulmonary infections or acquisition of MDR pathogen during ICU stay. In contrast, the patients who received a combination of antibiotics had a longer duration of mechanical ventilation. Although optimal antibiotic management for the treatment of VAP remains an issue, only few randomized controlled trials have addressed such results for PA-VAP.Based on most expert opinion, a combination of antibiotics is recommended to manage infections due to This recommendation is based on in vitro data [Both the IDSA and European guidelines [In contrast, our findings suggest that there was no advantage to use a combination therapy in terms of outcome, including MDR emergence. These results are consistent with available data in the literature. In a retrospective, multicenter, observational, cohort study, Garnacho-Montero et al. [The rate of VAP recurrence identified in our study was 13.6%. This rate was intermediate between the study of [Importantly, our results did not suggest an increased risk of acquisition of resistance due to the use of monotherapy, as it supported by two meta-analysis [