Aerosolized Antibiotic Therapy in Mechanically Ventilated Patients

Am J Respir Crit Care Med. 2024 Sep 15;210(6):730-736. doi: 10.1164/rccm.202402-0437CP.

Abstract

Delivering antibiotics directly to the respiratory tract through inhalation to address lung infections has garnered clinical and scientific interest for decades, given the potential favorable pharmacokinetic profile of this administration route. Among critically ill patients, the burden of healthcare-associated pulmonary infections particularly drove continued interest in delivering inhaled antibiotics to intubated patients. We present a concise overview of the existing rationale and evidence and provide guidance for implementing inhaled antibiotics among ventilated critically ill patients, emphasizing insights from recent literature.

Keywords: healthcare-associated pneumonia; inhalation; nebulization; ventilator-associated pneumonia.

Publication types

  • Review

MeSH terms

  • Administration, Inhalation
  • Aerosols
  • Anti-Bacterial Agents* / administration & dosage
  • Anti-Bacterial Agents* / pharmacokinetics
  • Anti-Bacterial Agents* / therapeutic use
  • Critical Illness / therapy
  • Humans
  • Pneumonia, Ventilator-Associated / drug therapy
  • Respiration, Artificial*
  • Respiratory Tract Infections / drug therapy

Substances

  • Anti-Bacterial Agents
  • Aerosols