title: Aerosolized antibiotics: do they add to the treatment of pneumonia?
abstract: OBJECTIVE
  The increasing rate of ventilator-associated pneumonia (VAP) caused by multidrug-resistant pathogens warrants the development of new treatment strategies. Carefully engineered delivery systems are undergoing evaluation to test the hypothesis that aerosolized administration of antibiotics will provide high local concentrations and fast clearance, which in turn may improve efficacy and decrease the risk of microbial resistance.
  
  
  RESULTS
  Recent studies indicate that aerosolized delivery systems for specially formulated antibiotics yield high local concentrations with rapid clearance and low systemic exposure. Preliminary clinical studies reveal that aerosolized delivery of antibiotics is well tolerated and active, when combined with intravenous antibiotics. No single aerosolized antibiotic is likely to provide broad-spectrum activity against both Gram-negative and Gram-positive bacteria.
  
  
  CONCLUSIONS
  Large multicenter trials are needed to determine whether preliminary findings will translate to improved clinical activity and decreased microbial resistance in VAP patients, and to optimize the use of aerosolized antibiotics.
authors.affiliation: aVirginia E. and Sam J. Golman Chair in Respiratory Intensive Care Medicine, Washington University School of Medicine, St. Louis, Missouri bVirginia Commonwealth University School of Pharmacy, Richmond cPrincipal, Hamilton House, Virginia Beach, Virginia dCardeas Pharma Corp., Seattle, Washington, USA.
authors.forename: Marin H
authors.initials: MH
authors.lastname: Kollef
authors.forename: Cindy W
authors.initials: CW
authors.lastname: Hamilton
authors.forename: A Bruce
authors.initials: AB
authors.lastname: Montgomery
mesh_terms: D000280:Administration, Inhalation; D000336:Aerosols; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002986:Clinical Trials as Topic; D024881:Drug Resistance, Bacterial; D006801:Humans; D053717:Pneumonia, Ventilator-Associated / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000336:Aerosols; D000900:Anti-Bacterial Agents