Aerosolized antibiotics to treat ventilator-associated pneumonia.
OBJECTIVE
This review summarizes the recent data on antibiotic aerosolization to treat ventilator-associated pneumonia.


RESULTS
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.


CONCLUSIONS
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.
Luyt
Charles-Edouard
CE
Service de Réanimation Médicale, Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, 47-83 boulevard de l'Hôpital, Paris Cedex 13, France. charles-edouard.luyt@psl.aphp.fr
Combes
Alain
A
Nieszkowska
Ania
A
Trouillet
Jean-Louis
JL
Chastre
Jean
J
D000280:Administration, Inhalation; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D006801:Humans; D053717:Pneumonia, Ventilator-Associated / Q000188:drug therapy*
D000900:Anti-Bacterial Agents