Ventilator-associated infection: the role for inhaled antibiotics

Current Opinion in Pulmonary Medicine
Lucy B Palmer

Abstract

Despite multiple protocols for the prevention of ventilator-associated pneumonia (VAP), respiratory infections have not been eliminated in the ICU. The profound disruption in both airway integrity and mucociliary clearance caused by the endotracheal tube makes it unlikely there will ever be a zero rate of respiratory infection in critically ill ventilated patients or a 100% cure rate when infection is present. In fact, options for treatment are diminishing as bacteria resistant to most, or in some hospitals all, systemic antibiotics increase in prevalence from our liberal use of systemic antibiotics. Inhaled therapy with proper delivery will result in the high concentrations of antibiotics needed in the treatment of increasingly resistant organisms. Data from many recent investigations have focused on inhaled antibiotics as: adjunctive therapy to systemic antibiotic for VAP, monotherapy for VAP, and as monotherapy for ventilator-associated tracheobronchitis. The clinical outcomes of these studies will be reviewed as well as their effect on multidrug-resistant organisms. The present review will focus on the rationale for inhaled therapy, the current studies examining the delivery and clinical efficacy of inhaled antibiotics, and...Continue Reading

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References

Jan 15, 1998·Critical Care Medicine·L B PalmerA Cuccia
Apr 6, 2002·American Journal of Respiratory and Critical Care Medicine·Jean Chastre, Jean-Yves Fagon
Dec 29, 2004·International Journal of Antimicrobial Agents·Jian LiKingsley Coulthard
Jan 22, 2005·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·David BerlanaR Jódar
Feb 8, 2005·Critical Care : the Official Journal of the Critical Care Forum·Argyris MichalopoulosMatthew E Falagas
Feb 9, 2005·American Journal of Respiratory and Critical Care Medicine·UNKNOWN American Thoracic Society, UNKNOWN Infectious Diseases Society of America
Apr 13, 2005·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Matthew E Falagas, Sofia K Kasiakou
Aug 5, 2005·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Andrea L H KwaVincent H Tam
Oct 11, 2005·Critical Care Medicine·Nasia SafdarSanjay Saint
Mar 27, 2007·Surgical Infections·Ali HallalCarl I Schulman
May 17, 2007·The European Respiratory Journal·F G RiosC Apezteguia
Oct 16, 2007·The Journal of Antimicrobial Chemotherapy·Eleni IoannidouMatthew E Falagas
Jan 4, 2008·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Brad SpellbergUNKNOWN Infectious Diseases Society of America
Mar 21, 2008·The New England Journal of Medicine·L Silvia Munoz-Price, Robert A Weinstein
Apr 23, 2008·Critical Care : the Official Journal of the Critical Care Forum·Alvaro Rea-NetoYasser Sakr
Jun 17, 2008·Critical Care Medicine·Lucy B PalmerPaul Richman
Jan 31, 2009·The New England Journal of Medicine·Cesar A Arias, Barbara E Murray
Mar 12, 2009·Current Opinion in Infectious Diseases·Saad NseirCharles-Hugo Marquette
Aug 22, 2009·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Lance R Peterson
Sep 8, 2009·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·I P KorbilaM E Falagas
Oct 3, 2009·Current Opinion in Infectious Diseases·Roger L Nation, Jian Li
Dec 3, 2009·JAMA : the Journal of the American Medical Association·Jean-Louis VincentUNKNOWN EPIC II Group of Investigators
Sep 22, 2010·Antimicrobial Agents and Chemotherapy·Jennifer H MoffattJohn D Boyce
Oct 27, 2010·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Diamantis P KofteridisGeorge Samonis
Apr 9, 2011·American Journal of Respiratory and Critical Care Medicine·Qin LuUNKNOWN Nebulized Antibiotics Study Group
Aug 27, 2011·Clinics in Chest Medicine·Lucy B Palmer
Feb 11, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Diana F FlorescuA C Kalil
May 25, 2012·Critical Care : the Official Journal of the Critical Care Forum·Sara Gil-PerotinJuan Bonastre
Jul 20, 2012·Intensive Care Medicine·Zoe E AthanassaGeorge J Baltopoulos
Jan 26, 2013·The Lancet Infectious Diseases·Elizabeth M H WellingtonA Prysor Williams
Feb 16, 2013·Current Opinion in Infectious Diseases·Philip E GrgurichDonald E Craven

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Citations

Aug 31, 2016·Expert Opinion on Drug Metabolism & Toxicology·Ilias KaraiskosHelen Giamarellou
Dec 7, 2016·Expert Review of Anti-infective Therapy·G PoulakouG Dimopoulos
Oct 19, 2017·Expert Opinion on Drug Delivery·Alejandro RodríguezLaurent Vecellio
Apr 20, 2019·Frontiers in Pharmacology·Xinming XieManxiang Li
Mar 19, 2015·Current Opinion in Pulmonary Medicine·Alimuddin Zumla, Michael S Niederman
Jul 26, 2017·Drugs·Garyphallia PoulakouGeorge Dimopoulos
Feb 26, 2016·Annals of Clinical Microbiology and Antimicrobials·Tuna DemirdalSalih Atakan Nemli

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