Abstract
There is lack of standardization of practices and limited evidence on efficacy and safety of nebulization of antimicrobials. We sought to determine inhalation practices in one tertiary care hospital by performing a cross-sectional survey. Eleven adult ICUs were included in the analysis. Three units followed established protocols. Ventilation circuit filters were exchanged at least daily in all but one units. Dosages of aminoglycosides and CMS depended on indication and unit. Nebulization of antimicrobials was generally regarded as safe and efficacious. Our data indicate that approach to nebulization of antimicrobials may be heterogeneous even in a single center.
Highlights
Guidelines for nebulization of antimicrobial agents vary
The German guidelines for treatment of nosocomial pneumonia indicate that inhaled administration of antibiotics should be considered in addition to systemic antibiotic therapy in patients with multidrug-resistant organisms (MDRO), which are only susceptible to polymyxins and/or aminoglycosides [1]
Recent international consensus guidelines for the optimal use of polymyxins advocate the use of adjunctive polymyxin aerosol therapy in patients with extensively resistant gram-negative nosocomial or ventilator-associated pneumonia (VAP) who require intravenous polymyxin [3]
Summary
Guidelines for nebulization of antimicrobial agents vary. The German guidelines for treatment of nosocomial pneumonia indicate that inhaled administration of antibiotics should be considered in addition to systemic antibiotic therapy in patients with multidrug-resistant organisms (MDRO), which are only susceptible to polymyxins and/or aminoglycosides [1]. Recent international consensus guidelines for the optimal use of polymyxins advocate the use of adjunctive polymyxin aerosol therapy in patients with extensively resistant gram-negative nosocomial or ventilator-associated pneumonia (VAP) who require intravenous polymyxin [3]. In this journal, Alves et al reported the results of an international cross-sectional survey on nebulization of antimicrobial agents in mechanically ventilated adults. Alves et al reported the results of an international cross-sectional survey on nebulization of antimicrobial agents in mechanically ventilated adults They found considerable heterogeneity of practice among participating intensive care units (ICU) from different continents [4]. We sought to determine inhalation practices systematically in our institution by performing a cross-sectional survey
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
