Should Aerosolized Antibiotics Be Used to Treat Ventilator-Associated Pneumonia?

Abstract:

:In patients with ventilator-associated pneumonia, systemic use of antibiotics is the cornerstone of medical management. Supplemental use of aerosolized antibiotics with intravenous antibiotics in both experimental and clinical studies has been shown to have the following pharmacologic benefits: (1) aerosolized antibiotics reach the infected lung parenchyma without crossing the pulmonary alveolar capillary barrier; (2) aerosolized antibiotics increase anti-bacterial efficacy through increased local antibiotic concentration; and (3) aerosolized antibiotics decrease systemic toxicity. These benefits may be particularly beneficial to treat pneumonia caused by multidrug-resistant pathogens. Clinical data on the benefits of aerosolized antibiotics are more limited. Studies to date have not clearly shown improvements in time to extubation, mortality, or other patient-centered outcomes. At present, amikacin, colistin, and ceftazidime are the most frequently used and studied aerosolized antibiotics. This review summarizes the characteristics of aerosolized antibiotics, reviews the advantages and disadvantages of using aerosolized antibiotics, and calls for future investigations based on animal study data.

journal_name

Respir Care

journal_title

Respiratory care

authors

Zhang C,Berra L,Klompas M

doi

10.4187/respcare.04748

subject

Has Abstract

pub_date

2016-06-01 00:00:00

pages

737-48

issue

6

eissn

0020-1324

issn

1943-3654

pii

61/6/737

journal_volume

61

pub_type

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