PROPHYLACTIC ANTIBIOTICS IN THE PREVENTION OF ASPIRATION PNEUMONIA IN STROKE PATIENTS

Abstract

Background: Stroke is a major cause of morbidity and mortality worldwide and is frequently complicated by aspiration pneumonia, which worsens clinical outcomes. Prophylactic antibiotics have been proposed as a preventive strategy; however, their efficacy remains controversial.

Objective: To determine the efficacy of prophylactic antibiotics in the prevention of aspiration pneumonia in stroke patients.

Methods: This randomized controlled trial was conducted in the Department of Medicine, Khyber Teaching Hospital, Peshawar, from 13th April 2025 to 13th July 2025. A total of 114 patients aged 40–80 years with confirmed stroke were enrolled and randomized into two groups. Group A received intravenous ceftriaxone (1 g twice daily for 5 days), while Group B received placebo. Patients were monitored for development of aspiration pneumonia. Data were analyzed using SPSS version 25, and efficacy was compared using chi-square test with p ≤0.05 considered significant.

Results: The mean age was comparable between groups (61.32 ± 9.45 vs 60.87 ± 10.12 years, p=0.78). Efficacy was significantly higher in Group A (93.0%) compared to Group B (71.9%) (p=0.003). Stratification analysis showed consistent benefit across age, gender, BMI, stroke type, and comorbidities.

Conclusion: Prophylactic antibiotics significantly reduce the risk of aspiration pneumonia in stroke patients and may be considered in high-risk individuals alongside standard preventive measures.