Efficacy of cotrimoxazole as a de-escalation treatment for adult patients Ventilator-Associated Pneumonia in intensive care unit Multicentre randomized non-inferiority trial comparing cotrimoxazole to standard antibiotic therapy for enterobacterial VAP
Adult patients hospitalized in an ICU
Under mechanical ventilation for at least five days
Microbiologically confirmed VAP preferably on a distal lung sample (bronchoalveolar lavage or protected distal specimen) otherwise endotracheal aspiration
Enterobacteriaceae susceptible to cotrimoxazole, and for polymicrobial VAP, all bacteria susceptible to cotrimoxazole
Haemodynamic instability (increasing dose of a catecholamine in the last 24 hours)
allergy,
advanced liver insufficiency,
renal dysfunction with clearance <15 mL/min/1.73 m² without hemodialysis