Flu Vaccine Didn ’ t Cut Pneumonia Risk in the Elderly

E tubes coated with silver, which has shown potent broad-spectrum antimicrobial activity in vitro, reduced the incidence of ventilatorassociated pneumonia by 35% in a multicenter study, researchers reported. “This is the first intervention demonstrated to reduce ventilator-associated pneumonia incidence that does not require more effort or supervision from clinicians providing bedside care,” said Dr. Marin H. Kollef, FCCP, of Washington University, St. Louis, and associates. However, the reduced rate of pneumonia did not translate into decreased mortality, duration of intubation, duration of ICU stay, duration of hospitalization, or frequency or severity of the adverse effects of intubation. In an editorial comment accompanying this report, Dr. Jean Chastre said that physicians should “probably” consider using silver-coated endotracheal tubes for “the subset of patients at very high risk of developing early-onset [ventilator-associated pneumonia], such as neurologically impaired patients or trauma patients.” But the value of the device for other patients, particularly those who might need prolonged ventilation, has not yet been clearly shown. Dr. Kollef and associates compared the silver-coated endotracheal tube with standard tubes in a prospective trial sponsored by the device manufacturer, C.R. Bard Inc. A total of 1,509 patients requiring me-