The researchers suggest from their findings that “antibiotic prophylaxis cannot be recommended for prevention of post-stroke pneumonia in patients with dysphagia after stroke managed in stroke units.”
A commentary notes that the Preventive Antibiotics in Stroke Study (PASS) also cast severe doubt on the effectiveness of these treatments. Its authors suggest that for clinical practice, there is now class 1 evidence recommending against such treatment with antibiotics, whilst for clinical research, the findings raise important questions such as why preventive anti-infective treatment is unable to prevent pneumonia after stroke. They add that the results from STROKE-INF and PASS raise another important issue: stroke guidelines recommend starting antibiotics early for treatment of stroke-associated pneumonia; however, commonly accepted criteria for diagnosing this disorder are not available. Furthermore, in order to improve strategies for prevention and treatment of stroke-associated pneumonia, well defined diagnostic criteria and a better understanding of the disorder are first needed.