VATICAN (Ventilator-Associated Tracheobronchitis Initiative to Conduct Antibiotic Evaluation): protocol for a multicenter randomized open-label trial of watchful waiting versus antimicrobial therapy for ventilator-associated tracheobronchitis

VATICAN Trial: Evaluating Antibiotic Treatment for Ventilator-Associated Tracheobronchitis

Background: Ventilator-associated tracheobronchitis is a common condition in intensive care units, and the best treatment strategy is currently unknown. The VATICAN trial aims to compare watchful waiting with routine antibiotic treatment for this condition.

Methods:

The VATICAN trial is a randomized, controlled, open-label, multicenter noninferiority trial. Patients with suspected ventilator-associated tracheobronchitis will be assigned to either a watchful waiting strategy or routine antimicrobial treatment for seven days. The primary outcome will be mechanical ventilation-free days at 28 days, with ventilator-associated pneumonia-free survival as a key secondary outcome.

Conclusion:

The VATICAN trial will adhere to ethical standards and aims to provide results that can immediately impact bedside care and guideline development.

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