Aerosolized antibiotics to treat ventilator-associated pneumonia.

Author(s): Luyt CE, Combes A, Nieszkowska A, Trouillet JL, Chastre J

Affiliation(s): Service de Reanimation Medicale, Institut de Cardiologie, Groupe Hospitalier Pitie-Salpetriere, 47-83 boulevard de l'Hopital, Paris Cedex 13, France. charles-edouard.luyt@psl.aphp.fr

Publication date & source: 2009-04, Curr Opin Infect Dis., 22(2):154-8.

Publication type: Review

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.