Effect of Gram Stain-Guided Initial Antibiotic Therapy on Clinical Response in Patients With Ventilator-Associated Pneumonia: The GRACE-VAP Randomized Clinical Trial.

Among patients with previous antibiotic therapy, the clinical response rate tended to be more favorable with the Gram stain–guided treatment than the guideline-based treatment (risk difference, 0.26; 95% CI, 0.01-0.50; P = .08 for interaction), although the interaction between an intervention effect and the existence of previous antibiotic therapy did not reach statistical significance.

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