TY - CHAP M1 - Book, Section TI - Chapter 64. Inhaled Antibiotic Therapy A1 - Rouby, Jean-Jacques A1 - Goldstein, Ivan A1 - Lu, Qin A2 - Tobin, Martin J. PY - 2013 T2 - Principles and Practice of Mechanical Ventilation, 3e AB - The incidence of ventilator-associated pneumonia ranges between 8% and 28% in patients receiving mechanical ventilation for more than 48 hours, and between 34% and 70% in patients with acute lung injury or acute respiratory distress syndrome.1 It prolongs the duration of stay in the intensive care unit and hospital, and increases costs.2 Associated mortality ranges from 24% to 76%, and appears far greater than the mortality resulting from other nosocomial infections. It may even exceed 85% when high-risk gram-negative bacteria, such as Pseudomonas aeruginosa or Acinetobacter baumannii, are the causative pathogens.3 Many studies demonstrate that early intravenous administration of appropriate antibiotics improves the prognosis. Lung deposition of antibiotics, however, administered by the intravenous route is either limited or poorly documented and treatment failure is common, leading to increased dosage and risk of systemic toxicity. Despite antimicrobial therapy and adequate supporting treatment, the mortality rate from ventilator-associated pneumonia remains high, indicating a need for a more effective route of administration. Inhaled antibiotic therapy may represent such an alternative. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/28 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=57081581 ER -