Aerosolized antibiotics to treat ventilator-associated pneumonia

Curr Opin Infect Dis. 2009 Apr;22(2):154-8. doi: 10.1097/QCO.0b013e328322a006.


Purpose of review: This review summarizes the recent data on antibiotic aerosolization to treat ventilator-associated pneumonia.

Recent findings: Most studies on antibiotic aerosolization have been case reports or descriptive studies. The results of a recent randomized, placebo-controlled trial indicated that adjunctive use of nebulized antibiotic with intravenous antibiotics to treat purulent tracheobronchitis was associated with a better outcome than placebo aerosolization. A randomized study, so far published only as an abstract, showed that amikacin aerosolized with a vibrating-mesh nebulizer--a new-generation device--was well distributed in the lung parenchyma and might lead to less intravenous antibiotic use. Several thorough reviews on nebulization devices, techniques and drawbacks have been published recently.

Summary: Despite recent promising findings, the widespread use of aerosolized antibiotics to treat ventilator-associated pneumonia cannot be recommended. It should be restricted to the treatment of multidrug-resistant Gram-negative ventilator-associated pneumonia.

Publication types

  • Review

MeSH terms

  • Administration, Inhalation
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / therapeutic use*
  • Humans
  • Pneumonia, Ventilator-Associated / drug therapy*


  • Anti-Bacterial Agents