RT Book, Section
A1 Rouby, Jean-Jacques
A1 Goldstein, Ivan
A1 Lu, Qin
A2 Tobin, Martin J.
SR Print(0)
ID 57081581
T1 Chapter 64. Inhaled Antibiotic Therapy
T2 Principles and Practice of Mechanical Ventilation, 3e
YR 2013
FD 2013
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-173626-8
LK accessanesthesiology.mhmedical.com/content.aspx?aid=57081581
RD 2024/04/19
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.