title: Aerosol delivery of antimicrobial agents during mechanical ventilation: current practice and perspectives.
abstract: Critically ill patients, who develop ventilator-associated pneumonia during prolonged mechanical ventilation, often require antimicrobial agents administered through the endotracheal or the tracheotomy tube. The delivery of antibiotics via the respiratory tract has been established over the past years as an alternative route in order to deliver high concentrations of antimicrobial agents directly to the lungs and avoid systemic toxicity. Since the only formal indications for inhaled/aerosolized antimicrobial agents is for patients suffering from cystic fibrosis, consequently the majority of research and published studies concerns this group of patients. Newer devices and new antibiotic formulations are currently off-label used in ambulatory cystic fibrosis patients whereas similar data for the mechanically ventilated patients do not yet exist.
authors.affiliation: Intensive Care Unit, "Henry Dunant" Hospital, Athens, Greece.
authors.forename: Argyris
authors.initials: A
authors.lastname: Michalopoulos
authors.forename: Eugenios I
authors.initials: EI
authors.lastname: Metaxas
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Falagas
mesh_terms: D000280:Administration, Inhalation; D000336:Aerosols; D000890:Anti-Infective Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D003422:Critical Care / Q000639:trends*; D004339:Drug Compounding / Q000639:trends; D016503:Drug Delivery Systems / Q000639:trends; D006801:Humans; D036501:Metered Dose Inhalers / Q000639:trends; D009330:Nebulizers and Vaporizers / Q000639:trends; D053717:Pneumonia, Ventilator-Associated / Q000188:drug therapy*; D012121:Respiration, Artificial / Q000009:adverse effects*
chemical_list: D000336:Aerosols; D000890:Anti-Infective Agents