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Inhaled amikacin versus placebo to prevent ventilator-associated pneumonia: the AMIKINHAL double-blind multicentre

Elsa Tavernier1, Francois Barbier2, Ferhat Meziani3

  • 1Inserm CIC 1415, CHRU Tours, Tours, France.

BMJ Open
|September 15, 2021
PubMed
Abstract

Insights

Pre-emptive inhaled antibiotics, given for three days, may reduce ventilator-associated pneumonia in critically ill patients. This approach also shows promise in lowering antibiotic resistance, a significant clinical concern.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Pulmonology

Background:

  • Ventilator-associated pneumonia (VAP) is a common complication in critically ill patients requiring invasive mechanical ventilation.
  • Existing meta-analyses suggest a potential benefit of pre-emptive inhaled antibiotics in reducing VAP occurrence.
  • Inhaled antibiotics may also mitigate the emergence of antibiotic-resistant bacteria.

Purpose of the Study:

  • To evaluate the efficacy of a 3-day course of inhaled antibiotics in preventing ventilator-associated pneumonia.
  • To assess the impact of inhaled amikacin on VAP occurrence in patients on invasive mechanical ventilation for over 3 days.

Main Methods:

  • A multicentre, double-blind, randomized controlled superiority trial.
  • Patients invasively ventilated for >3 days were randomized to receive daily inhaled amikacin (20 mg/kg) or placebo for 3 days.
  • VAP occurrence was monitored from randomization to day 28 and adjudicated by a blinded committee.

Main Results:

  • Data on main results are not yet available as this is a protocol description.

Conclusions:

  • The study aims to provide robust evidence on the effectiveness of inhaled antibiotics for VAP prevention.
  • Findings could inform clinical guidelines for managing mechanically ventilated patients.
  • The trial may contribute to strategies for combating antibiotic resistance in intensive care settings.
Keywords:
adult intensive & critical careclinical trialsinfectious diseasesrespiratory infections

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