6/28/23, 12:42 AM ANTHARTIC Pathway Feedback Search Clinical Topics Home Studies ANTHARTIC ANTHARTIC Disease Cardiac arrest Trial question What is the role of preventive short-term antibiotic therapy in patients treated with targeted temperature management after out-of-hospital cardiac arrest with shockable rhythm? Study design Multi-center Double blinded RCT Population Characteristics of study participants 19.4% female N = 198 80.6% male 198 patients (38 female, 156 male) Inclusion criteria: adult patients in ICUs who were being mechanically ventilated after out-of- hospital cardiac arrest related to initial shockable rhythm and treated with targeted temperature management at 32 to 34 C Key exclusion criteria: ongoing antibiotic therapy, chronic colonization with multidrug-resistant bacteria, or moribund status Interventions N=99 antibiotic (intravenous amoxicillin-clavulanate at doses of 1 g and 200 mg TID for 2 days, starting < 6 hours after the cardiac arrest) N=95 control (intravenous saline TID for 2 days, starting < 6 hours after the cardiac arrest) https://web.pathway.md/studies/recsxizbDgSi8k3VE 1/2 6/28/23, 12:42 AM ANTHARTIC Pathway Primary outcome Early ventilator-associated pneumonia 34.0 % 34 25.5 % 19 17.0 % Significant decrease 8.5 % NNT = 7 0.0 % Antibiotic Control Significant decrease in early ventilator-associated pneumonia (19% vs. 34%; HR 0.53, 95% CI 0.31 to 0.92) Secondary outcomes Significant decrease in the rate of cumulative incidence of ventilator-associated pneumonia on day 5 (17% vs. 31%; HR 0.53, 95% CI 0.3 to 0.95) No significant difference in death at day 28 (41% vs. 37%; AD 4%, 95% CI -10 to 18) Safety outcomes No significant difference in serious adverse events. Significant differences in heart diseases (0.12% vs. 0.06%), respiratory, thoracic, and mediastinal diseases (0.02% vs. 0.08%). Conclusion In adult patients in ICUs who were being mechanically ventilated after out-of-hospital cardiac arrest related to initial shockable rhythm and treated with targeted temperature management at 32 to 34 C, antibiotic was superior to control with respect to early ventilator-associated pneumonia. Reference Bruno Fran ois, Alain Cariou, Rapha l Clere-Jehl et al. Prevention of Early Ventilator-Associated Pneumonia after Cardiac Arrest. N Engl J Med. 2019 Nov 7;381(19):1831-1842. Open reference URL https://web.pathway.md/studies/recsxizbDgSi8k3VE 2/2