Role of Prophylactic Antibiotics in Preventing Stroke-Associated Pneumonia in Patients with Ischemic Stroke

Abstract

Objective: To compare the frequency of stroke-associated pneumonia in patients given prophylactic antibiotics versus those not given prophylactic antibiotics. Study Design: Comparative Cross-sectional study. Place and Duration of Study: The study was carried out at the Department of Internal Medicine, Combined Military Hospital (CMH), Peshawar, Pakistan from 1st August 2022 to 31st January 2023. Methods: We included 250 ischemic stroke patients and divided them into groups A, “Prophylactic group,” and B, “no prophylactic antibiotics group.” Patients were assessed at 7 days after admission for presence of “stroke associated pneumonia (SAP)” through clinical examination and chest X-rays. Data were analyzed using a statistical package for social sciences 22. For qualitative variables, frequency and percentages were used, whereas for quantitative data, the median (IQR) was used as the data were not normally distributed and contained outliers; using the median and IQR can be more appropriate for describing the central tendency and spread of the data compared to the mean and standard deviation. Results: In our study, the median age of the patients was 68(46-83) years. 61 (24.40%) of the patients were male while 189(75.60%) were female. The median BMI was 31 (19-44) kg/m2. Diabetes was present in 123 (49.20%) patients and 96(38.40%) had hypertension. We found that in the “prophylactic antibiotics” group (A), 9 (7.20%) patients developed SAP, while in the “no prophylactic antibiotics” group (B) frequency of SAP was 34 (27.20%) (p< 0.001). Conclusion: Prophylactic antibiotics used in “ischemic stroke” patients provide better outcomes by reducing the incidence of “stroke-associated pneumonia”. Therefore, it should be given to all patients admitted to the hospital with ischemic CVA.