Patients admitted to the ICU are isolated with “Droplet Precautions” Intubated ventilated and suctioned every two hours with perhaps a closed suction system and then open suction technique when precautions lifted 24 hours after starting antibiotic therapy.
Any thoughts or references in medico-scientific literature will be helpful.
D Arbon
As Health and Safety Rep.
Thanks Fabio,
A check of the references in some guidelines lead me to
'Persistence of Neisseria in the upper respiratory tract after intravenous antibiotic therapy for systemic meningiococcal disease; by Abramson J S and Spilka J S . Journal of Infectious diseases 1985 Feb 151(2)370-1
An article that is quite hard to access, has a small sample size,14, and may suggest that after 24 hour relative risk to the hospital population is small. However the statements that ' N meningitis was not cultured from the respiratory tract of any of the patients 24 hours after the institution of iv antibiotics' and ' The strain of N Meningitidis causing the infection was cultured from from the respiratory tract of one patient at the termination of iv antibiotic therapy and four patients (28.6%) had positive cultures one week after completion of therapy.' Seems somewhat contradictory to me. I wonder if it was followed up?
I still need some good studies to back up the idea that precautions for ventilated ICU patients can be lifted after 24 hours of IV therapy. :)
DA