Inhaled Amikacin to Prevent Ventilator-Associated Pneumonia – Article

background

It is unclear whether antibiotics inhaled Preventive measures can reduce the incidence of ventilator-associated pneumonia.

method

In this multicenter, double-blind, randomized, controlled, investigator-initiated superiority trial, we assigned critically ill adults who had been receiving invasive mechanical ventilation for at least 72 hours to treatment inhaled amikacin

The dose is 20 mg/kg body weight once daily or placebo for 3 days.

he main ending This was the first occurrence of ventilator-associated pneumonia during the 28-day follow-up period. Safety was assessed.

result

A total of 850 patients were randomized, of whom 847 were included in the analysis (417 patients were assigned to the amikacin group and 430 patients were assigned to the placebo group). 337 patients (81%) in the amikacin group received nebulized therapy three times daily, and 355 patients (83%) in the placebo group received nebulized therapy three times daily.

At 28 days, it was already fully developed ventilator associated pneumonia 62 patients (15%) in the amikacin group and 95 patients (22%) in the placebo group (limited median survival difference for ventilator-associated pneumonia, 1.5 days; 95% confidence interval (CI), 0.6) to 2.5; P = 0.004).