A clinical trial to determine if antibiotics prevent chest infections in patients with brain injuries requiring life support in the intensive care unit

Lower respiratory tract (chest) infections are a common complication in patients placed onto mechanical ventilation (life support) in the intensive care unit (ICU). Patients with brain injuries who require invasive mechanical ventilation may be particularly susceptible to chest infections – the consequence of which may be worsening of their neurological injury. A recent multi-centre randomised clinical trial showed a significant reduction in ventilator associated pneumonia in mechanically ventilated patients after out of hospital cardiac arrest who received prophylactic (preventative) antibiotics starting within 6 hours of cardiac arrest. It is possible that patients with acute brain injuries would also benefit from this strategy as indicated by small pilot studies but it is not known whether this will lead to patient important outcomes such as increased survival with a favourable neurological outcome. This study aims to answer the question, do prophylactic antibiotics reduce the occurrence of lower respiratory tract infections in adults with acute neurological injuries requiring mechanical ventilation. This will then inform the design of a phase 3 trial testing the hypothesis that this treatment regime will increase survival with a favourable outcome at day 180 in these patients.