Aerosolized antibiotics to treat ventilator-associated pneumonia
Charles-Edouard Luyt1, Alain Combes, Ania Nieszkowska
1Service de Réanimation Médicale, Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, 47-83 boulevard de l'Hôpital, Paris Cedex 13, France. charles-edouard.luyt@psl.aphp.fr
Purpose Of Review:
This review summarizes the recent data on antibiotic aerosolization to treat ventilator-associated pneumonia.
Recent Findings:
Most studies on antibiotic aerosolization have been case reports or descriptive studies. The results of a recent randomized, placebo-controlled trial indicated that adjunctive use of nebulized antibiotic with intravenous antibiotics to treat purulent tracheobronchitis was associated with a better outcome than placebo aerosolization. A randomized study, so far published only as an abstract, showed that amikacin aerosolized with a vibrating-mesh nebulizer--a new-generation device--was well distributed in the lung parenchyma and might lead to less intravenous antibiotic use. Several thorough reviews on nebulization devices, techniques and drawbacks have been published recently.
Summary:
Despite recent promising findings, the widespread use of aerosolized antibiotics to treat ventilator-associated pneumonia cannot be recommended. It should be restricted to the treatment of multidrug-resistant Gram-negative ventilator-associated pneumonia.
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