INHALED ANTIBIOTICS FOR TREATING PNEUMONIA IN INVASIVELY VENTILATED PATIENTS IN THE INTENSIVE CARE UNIT

Authors

  • BA ABDELRAHMAN Pharmaceutical Care Department, King Saud Medical City, Riyadh, Saudi Arabia
  • MA RANA Amna Inayat Medical College/ Consultant Intensivist Bahria International Hospital, Lahore, Pakistan
  • AHA AWAD Rashid Hospital, Dubai Health, Dubai, UAE
  • AM ABDELBAKY Rashid Hospital, Dubai Health, Dubai, UAE
  • WG ELMASRY Rashid Hospital, Dubai Health, Dubai, UAE
  • MH SIDDIQUI Department of Medicine, Akhtar Saeed Medical and Dental College, Lahore, Pakistan
  • M AHMAD Lahore Grammar School (LGS), Lahore, Pakistan

DOI:

https://doi.org/10.54112/pjicm.v4i02.33

Keywords:

Pneumonia, Ventilator-Associated, Respiratory Tract Infections, Inhalation Administration, Antibiotics, Inhaled, Drug Resistance, Bacterial, Pseudomonas Infections, Acinetobacter Infections, Critical Care

Abstract

Pneumonia in invasively ventilated patients is a significant concern in the intensive care unit (ICU), often associated with increased morbidity, prolonged hospital stays, and high mortality rates. The emergence of multidrug-resistant (MDR) pathogens further complicates management. Inhaled antibiotics (IABs) have gained attention as an adjunctive or alternative treatment modality to systemic antibiotics, offering direct drug delivery to the lungs with potentially enhanced efficacy and reduced systemic toxicity. This review explores the role of inhaled antibiotics in treating pneumonia in invasively ventilated patients, focusing on pharmacological considerations, clinical efficacy, safety profiles, and limitations. Relevant evidence is derived from databases such as PubMed, Scopus, Web of Science, and Google Scholar, incorporating the latest studies and clinical trials to provide a comprehensive understanding.

References

Chastre J, Fagon JY. Ventilator-associated pneumonia. Am J Respir Crit Care Med. 2002;165(7):867-903.

Niederman MS. Inhaled antibiotics for ventilator-associated pneumonia: contemporary issues and clinical evidence. Infect Dis Clin North Am. 2010;24(3):513-524.

Rello J, Sole-Lleonart C, Rouby JJ, et al. Use of nebulized antibiotics for the treatment of respiratory infections in invasively ventilated critically ill adult patients. Intensive Care Med. 2017;43(7):1002-1016.

Torres A, Ferrer M, Badia JR. Treatment guidelines and outcomes of hospital-acquired and ventilator-associated pneumonia. Clin Infect Dis. 2010;51(Suppl 1):S48-S53.

Palmer LB, Smaldone GC. Aerosolized antibiotics in the ICU. Clin Chest Med. 2011;32(3):559-574.

Michalopoulos A, Fotakis D, Virtzili S, et al. Aerosolized colistin as adjunctive treatment of ventilator-associated pneumonia: a prospective study. Respir Med. 2008;102(3):407-412.

Krueger WA, Welte T, Ballmann M, et al. Inhaled antibiotics in mechanically ventilated patients. Infect Drug Resist. 2015;8:187-198.

Lu Q, Lévy H, Vidal V, et al. Nebulized antibiotics for ventilator-associated pneumonia. Curr Opin Infect Dis. 2012;25(2):194-200.

Fink JB. Aerosolized antibiotics: part of the solution or part of the problem? Respir Care. 2007;52(5):622-644.

Kollef MH, Golan Y, Micek ST, et al. Clinical outcomes of linezolid in treating nosocomial pneumonia caused by methicillin-resistant Staphylococcus aureus. Chest. 2004;126(3):767-777.

Wood GC, Swanson JM, Tang L, et al. Aerosolized antibiotics in the treatment of ventilator-associated pneumonia: an observational study. Crit Care. 2012;16(3):R82.

Ioannidou E, Siempos II, Falagas ME. Administration of antimicrobial agents by inhalation for the treatment of patients with nosocomial pneumonia: a meta-analysis. J Antimicrob Chemother. 2007;60(6):1216-1226.

Kalil AC, Metersky ML, Klompas M, et al. Management of adults with hospital-acquired and ventilator-associated pneumonia. Clin Infect Dis. 2016;63(5):e61-e111.

Baran DA, Karlin J, Marcus S, et al. Inhaled antibiotics for ventilator-associated pneumonia: a narrative review. Pulm Pharmacol Ther. 2021;69:102020.

Niederman MS, Chastre J, Corkery K, et al. Guidelines for the management of adults with ventilator-associated pneumonia. Am J Respir Crit Care Med. 2015;191(4):388-396.

Torres A, Niederman MS, Chastre J, et al. Inhaled antibiotics for VAP: consensus statement. Int J Infect Dis. 2017;64:43-51.

Bassetti M, Repetto E, Righi E, et al. Colistin inhalation therapy in ventilator-associated pneumonia. Crit Care Med. 2016;44(5):e320-e325.

Zampieri FG, Nassar AP Jr, Gusmao-Flores D, et al. Inhaled antibiotics in critically ill patients: systematic review. Respir Med. 2017;132:132-138.

Restrepo MI, Peters JI. Inhaled antibiotics for pneumonia. J Aerosol Med Pulm Drug Deliv. 2018;31(1):17-29.

Hassan T, El-Naggar W, Abdelrahman SA, et al. Pharmacokinetics of aerosolized antibiotics. Crit Care. 2015;19:182.

Lin GL, McGinley J, Ranjan R, et al. Advances in aerosol delivery systems for inhaled antibiotics. Curr Opin Pulm Med. 2019;25(3):238-245.

Kwak SH, Jo EJ, Kim J, et al. Nebulized colistin in ventilator-associated pneumonia: a systematic review and meta-analysis. Crit Care Med. 2020;48(11):e1040-e1047.

Li J, Nation RL, Turnidge JD, et al. Colistin: the re-emerging antibiotic for multidrug-resistant gram-negative bacterial infections. Lancet Infect Dis. 2006;6(9):589-601.

Beale RJ, Hagmeyer L, Morrison J, et al. Nebulized antibiotics in mechanically ventilated patients. Curr Opin Pulm Med. 2016;22(3):222-227.

Munoz-Price LS, Weinstein RA. Acinetobacter infection. N Engl J Med. 2008;358(12):1271-1281.

Roger C, Chabrier S, Blasco G, et al. Pharmacokinetics of nebulized antibiotics in mechanically ventilated patients. Crit Care. 2018;22(1):109.

Cheah SE, Li J, Nation RL, et al. Colistin and polymyxin B: pharmacology, pharmacokinetics, and nephrotoxicity. Adv Pharmacol. 2019;79:1-33.

Torres A, Rello J, Niederman MS, et al. Inhaled antibiotic therapy for ventilator-associated pneumonia: rationale, evidence, and potential improvements. Int J Infect Dis. 2018;77:149-157.

Downloads

Published

2024-11-30

How to Cite

ABDELRAHMAN , B., RANA , M., AWAD , A., ABDELBAKY , A., ELMASRY , W., SIDDIQUI , M., & AHMAD, . M. (2024). INHALED ANTIBIOTICS FOR TREATING PNEUMONIA IN INVASIVELY VENTILATED PATIENTS IN THE INTENSIVE CARE UNIT. Pakistan Journal of Intensive Care Medicine, 4(02), 33. https://doi.org/10.54112/pjicm.v4i02.33

Issue

Section

Review Articles

Most read articles by the same author(s)

1 2 > >>