Aerosolized antibiotics in critically ill ventilated patients.
OBJECTIVE
This review will summarize recent clinical data examining the efficacy of aerosolized antimicrobial therapy in treating respiratory tract infections in mechanically ventilated patients in the ICU.


RESULTS
Aerosolized antibiotics provide high levels of drug in the lung and reduce the systemic toxicity associated with intravenous antibiotics. First introduced in the 1970s as a form of prophylaxis for ventilator-associated pneumonia (VAP), now, more than 30 years later, there is a resurgence of interest in using this mode of delivery as primary or adjunctive treatment for ventilator-associated tracheobronchitis (VAT) or VAP. Increasingly resistant organisms are colonizing and infecting critically ill patients, and direct delivery of antibiotic to the lung is being re-evaluated as a means to treat these highly resistant organisms that may not respond to systemic therapy. There are new data emerging that suggest these agents may effectively treat these pathogens when used in targeted, time limited protocols.


CONCLUSIONS
Aerosolized antibiotic therapy may provide an efficacious means of treating respiratory tract infection when targeted at mechanically ventilated patients with proximal airway infection, VAT (with or without VAP) and with highly resistant organisms.
Palmer
Lucy B
LB
Pulmonary Critical Care Division, State University of New York, Department of Medicine, Stony Brook, New York 11794-8172, USA. lbpalmer@notes.cc.sunysb.edu
D000280:Administration, Inhalation; D000336:Aerosols; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001991:Bronchitis / Q000188:drug therapy; D002986:Clinical Trials as Topic; D016638:Critical Illness; D016503:Drug Delivery Systems; D024881:Drug Resistance, Bacterial; D006801:Humans; D007362:Intensive Care Units; D053717:Pneumonia, Ventilator-Associated / Q000188:drug therapy / Q000517:prevention & control; D012121:Respiration, Artificial; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000517:prevention & control; D014136:Tracheitis / Q000188:drug therapy
D000336:Aerosols; D000900:Anti-Bacterial Agents