Antibiotic prophylaxis is ineffective in preventing pneumonia post-stroke

STROKE-INF aimed to evaluate whether prophylactic
antibiotics could prevent the development of pneumonia
in patients with dysphagia after acute stroke. The study
was a prospective cluster-randomised open-label
controlled trial. Patients were enrolled within 48 hours
of stroke onset. In total, 48 stroke units across the UK
were randomly assigned to deliver standard stroke unit
care with prophylactic antibiotics or standard stroke
unit care alone. The antibiotic regimens were left to the
discretion of the investigators but largely consisted of a
β-lactam (amoxicillin or co-amoxiclav) with or without
clarithromycin. The primary outcome measure was the
development of pneumonia in the first 14 days, defined
using a criteria-based algorithm and also as diagnosed by
a physician. Suspected infections could be treated with
additional antibiotics.