Association of Empirical Aerobic Antibiotic Therapy with Clinical Improvement and Mortality in Critically Ill Patients Receiving Mechanical Ventilation

Background: Infection and sepsis represent critical conditions that contribute significantly to mortality among patients in intensive care units, rendering the selection of appropriate empirical antibiotic therapy a crucial aspect of clinical management. Aim: This study aimed to analyze the association between empirical antibiotic therapy with aerobic compared to anaerobic coverage and total clinical improvement as well as mortality within 7 days in critically ill patients receiving mechanical ventilation. Methods: A retrospective analytical observational study was conducted among ICU and High Care Unit patients at X Hospital Jember from January 2024 to December 2025 using total sampling, yielding 232 subjects who met the inclusion criteria from 665 admitted patients. Results: Data were collected from electronic medical records and analyzed through univariate, bivariate using Chi-Square test, and multivariate analyses using binary logistic regression with SPSS 25. A total of 170 patients (73.3%) received aerobic antibiotics and 62 patients (26.7%) received anaerobic antibiotics. Antibiotic coverage shows no significant association with mortality within 7 days (p-value =0.643) or total clinical improvement (p-value =0.948). Multivariate analysis reveals that a history of surgical procedure is significantly associated with increased clinical improvement (aOR 2.709 (1,527 – 4,806); p-value =0.001) and reduced mortality within 7 days (aOR 0.442 (0,175 – 1,116); p-value =0.012), while ICU admission (aOR 0.363 (0,161 – 0,820); p-value =0.015) and blood transfusion therapy (aOR 0.279 (0,124 – 0,631); p-value =0.002) are also significantly associated with reduced mortality. Conclusion: Empirical antibiotic therapy with either aerobic or anaerobic coverage demonstrates no statistically significant difference in influencing clinical outcomes among critically ill patients receiving mechanical ventilation.