Combination of granulocyte colony-stimulating factor and antibacterial drugs for the treatment of ventilatory associated nosocomial pneumonia.

: In this prospective study, we aimed to investigate the role of Granulocyte Colony-Stimulating Factor (rhG-CSF) supplement to antibiotherapy, for the treatment of ventilator-associated nosocomial pneumonia (VAP) in patients intubated due to acute respiratory failure. In Emergency Intensive Care Unit (EICU), 28 patients on mechanical ventilation are randomised into two groups as rhG-CSF and control, after they are diagnosed to have VAP. The first group received 5 micrograms/kg/day subcutaneous rhG-CSF as a supplement to antibiotherapy while in the second group the sole treatment was antibiotherapy. For each patient studied, the chart is reviewed at the first day of mechanical ventilation and for 8 days after VAP for the following parameters: erythrocyte, leucocyte, granulocyte and platelet counts; SGOT, SGPT, blood urea, creatinine; microbiological analyses of transtracheal aspirate, hemocultures and infiltrations shown on chest x-ray. APACHE II scores of patients are also recorded. Statistical comparisons among groups are performed with Mann-Whitney U test. The groups didn't differ significantly in erythrocyte, platelet counts and blood urea, creatinine, SGOT, SGPT (p > 0.05). The difference is found to be much more significant according to leucocyte and granulocyte counts in rhG-CSF group, when compared to control group (p < 0.001). We conclude, that combination of antibacterial agents and rhG-CSF may be beneficial for the treatment of VAP.