Nebulized Versus IV Amikacin as Adjunctive Antibiotic for Hospital and Ventilator-Acquired Pneumonia Postcardiac Surgeries: A Randomized Controlled Trial

Miguel Zayas, Mercer University College of Pharmacy

Pneumonia is the most common infection in mechanically ventilated patients with risk of infection being associated with duration of mechanical ventilation. [1] The 2016 Infectious Disease Society of America (IDSA) guideline on healthcare and ventilator associated pneumonia (HAP and VAP) currently recommends a beta-lactam antibiotic along with either an intravenous (IV) fluoroquinolone or IV aminoglycoside. The use of inhaled aminoglycosides is recommended as a treatment of last resort if patients are not responsive to IV antibiotics alone (weak recommendation, very low-quality of evidence). [2] However, recently, nebulized antibiotics use as an adjunctive therapy has been increasing due to the decreased risk of nephrotoxicity and greater localization at the intended site of action when treating suspected multi-drug resistant gram-negative bacilli (MDR-GNB). [3,4]

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