Document Detail


Delivering antibiotics to the lungs of patients with ventilator-associated pneumonia: an update.
MedLine Citation:
PMID:  23627857     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Ventilator-associated pneumonia is a serious hospital-acquired infection, with 20-70% crude mortality and 10-40% estimated attributable mortality. Insufficient antibiotic concentrations at the infection site when these drugs are given intravenously may lead to poor outcomes, particularly when difficult-to-treat pathogens are responsible; for example, Pseudomonas aeruginosa, extended spectrum beta lactamase-producing Gram-negative bacilli, Acinetobacter spp. and/or methicillin-resistant Staphylococcus aureus. Direct drug delivery to the infection site via aerosolization combined with intravenous administration achieves concentrations exceeding MICs of the pathogens, even those with impaired susceptibility. Experimental and recent clinical results demonstrated our markedly improved ability to deliver aerosolized antibiotics to the lung with new-generation devices, for example, vibrating-mesh nebulizers. Convincing clinical data from a large randomized trial are still lacking to support the routine administration of aerosolized antibiotics to treat ventilator-associated pneumonia, even though some small-randomized trials' observations are encouraging.
Authors:
Charles-Edouard Luyt; Nicolas Bréchot; Alain Combes; Jean-Louis Trouillet; Jean Chastre
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Expert review of anti-infective therapy     Volume:  11     ISSN:  1744-8336     ISO Abbreviation:  Expert Rev Anti Infect Ther     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101181284     Medline TA:  Expert Rev Anti Infect Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  511-21     Citation Subset:  IM    
Affiliation:
Service de Réanimation Médicale, Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris, 47-83, Boulevard de l'Hôpital, 75651 Paris Cedex 13, France and Université Paris 6, Pierre et Marie Curie, Paris, France.
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