Journal Article

Other Therapeutic Modalities and Practices: Implications for Clinical Trials of Hospital-Acquired or Ventilator-Associated Pneumonia

Jean Chastre and Charles-Edouard Luyt

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 51, issue Supplement_1, pages S54-S58
Published in print August 2010 | ISSN: 1058-4838
Published online August 2010 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/653050
Other Therapeutic Modalities and Practices: Implications for Clinical Trials of Hospital-Acquired or Ventilator-Associated Pneumonia

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Direct delivery of antimicrobial agents to the site of infection via aerosolization may represent a valid option in patients with ventilator-associated pneumonia (VAP). Although promising and supported by the results of several recent investigations, antibiotic aerosolization to treat VAP has not yet entered the armamentarium for daily practice. Its potential efficacy should be first evaluated as an adjunctive therapy in a superiority trial in which all participants receive a standard-of-care intravenous regimen and then are randomized to receive additional antibiotics by aerosol or a placebo (eg, combination therapy trials). Inclusion criteria should specifically target patients with microbiologically proven VAP caused by potentially multidrug-resistant strains, because a clear benefit of aerosolized antibiotics is awaited in only this subpopulation. Until results of these trials are known, antibiotic aerosolization can be recommended only for treating patients with multidrugresistant VAP, for which no effective intravenous regimen is available.

Journal Article.  3545 words. 

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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