Inhaled Antibiotics for Ventilator-Associated Infections

Infect Dis Clin North Am. 2017 Sep;31(3):577-591. doi: 10.1016/j.idc.2017.05.006.

Abstract

Multidrug-resistant organisms are creating a challenge for physicians treating the critically ill. As new antibiotics lag behind the emergence of worsening resistance, intensivists in countries with high rates of extensively drug-resistant bacteria are turning to inhaled antibiotics as adjunctive therapy. These drugs can provide high concentrations of drug in the lung that could not be achieved with intravenous antibiotics without significant systemic toxicity. This article summarizes current evidence describing the use of inhaled antibiotics for the treatment of bacterial ventilator-associated pneumonia and ventilator-associated tracheobronchitis. Preliminary data suggest aerosolized antimicrobials may effectively treat resistant pathogens with high minimum inhibitory concentrations.

Keywords: Inhaled antibiotics; Multidrug-resistant bacteria; Ventilator-associated pneumonia; Ventilator-associated tracheobronchitis.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / therapeutic use
  • Drug Resistance, Multiple, Bacterial
  • Humans
  • Pneumonia, Ventilator-Associated / drug therapy*
  • Pneumonia, Ventilator-Associated / microbiology
  • Respiration, Artificial
  • Respiratory Tract Infections / drug therapy*
  • Respiratory Tract Infections / microbiology

Substances

  • Anti-Bacterial Agents