François B, Cariou A, Clere-Jehl R, et al. - Given an increased risk for ventilator-associated pneumonia among patients who are treated with targeted temperature management after out-of-hospital cardiac arrest with shockable rhythm, researchers examined how preventive short-term antibiotic therapy influence this risk. In this multicenter, double-blind, randomized, placebo-controlled trial, 198 adult patients (> 18 years of age) in intensive care units (ICUs) were randomized to receive either intravenous amoxicillin–clavulanate (at doses of 1 g and 200 mg, respectively) or placebo three times a day for 2 days, starting less than 6 hours after the cardiac arrest. The analysis was performed on 194 patients; of these, 60 cases were identified to have ventilator-associated pneumonia, including 51 of early ventilator-associated pneumonia. They observed a lower incidence of early ventilator-associated pneumonia in patients receiving a 32-to-34°C targeted temperature management strategy after out-of-hospital cardiac arrest with initial shockable rhythm in correlation to receipt of a 2-day course of antibiotic therapy with amoxicillin–clavulanate vs placebo. No significant between-group differences were evident in terms of ventilator-free days and mortality at day 28.