Prophylactic Antibiotic Administration in Adults with Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-analysis

Abstract Background: There is a debt whether prophylactic antibiotic use may further hamper prognosis of patients with OHCA. In this study, we have performed a meta-analysis to assessed the effect of prophylactic antibiotic administration. Methods: Electronic databases were searched for trials in which prophylactic antibiotic had been administered to adults with OHCA. The predefined primary outcome was the incidence of pneumonia. Results: The included 6 trials enrolled a total of 5061 patients. Prophylactic antibiotic administration was not associated with decreased incidence of pneumonia and early-onset pneumonia (OR 0.44; 95%CI (0.19, 1.02); p= 0.056; I 2 =95.9% vs. OR 0.54; 95%CI (0.22, 1.32); p= 0.175; I 2 =46.8%). No adverse effect on mortality was found among trials (OR 1.17; 95%CI (0.46, 2.97); p= 0.748; I 2 =87.8%). Conclusion: Given this conflicting collection of limited quality, no difference in the incidence of pneumonia (including early-onset pneumonia) and mortality was found when receiving prophylactic antibiotic administration in patients suffering out-of-hospital cardiac arrest. Randomized trials are warranted to define the best prophylactic antibiotic protocol. PROSPERO registration number : CRD42022341601. 07 March, 2022 retrospectively registered.