Preventing lower airway colonization and infection in mechanically ventilated patients.
We report the results of a prophylactic regime designed to prevent endogenous colonization and infection of the lower airways by Gram-negative bacilli. The 27 study patients spent an average of 30 days (range 11 to 84) in the respiratory ICU, during which time they were on mechanical ventilation. Within 3 days of application of 2% polymyxin E and tobramycin in an adhesive paste to the buccal mucosa, the oral cavity of each patient was free of Gram-negative bacilli, and subsequently, no patient developed tracheal aspirates containing Gram-negative bacilli, and no study patient developed nosocomial pneumonia.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003091:Colistin / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000517:prevention & control; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000009:adverse effects*; D012137:Respiratory System / Q000382:microbiology; D012141:Respiratory Tract Infections / Q000209:etiology / Q000517:prevention & control*; D014031:Tobramycin / Q000008:administration & dosage
D000900:Anti-Bacterial Agents; D014031:Tobramycin; D003091:Colistin