| Title |
Nebulization of antimicrobial agents in mechanically ventilated adults in 2017: an international cross-sectional survey
|
|---|---|
| Published in |
European Journal of Clinical Microbiology & Infectious Diseases, January 2018
|
| DOI | 10.1007/s10096-017-3175-5 |
| Pubmed ID | |
| Authors |
Joana Alves, Emine Alp, Despoina Koulenti, Zhongheng Zhang, Stephan Ehrmann, Stijn Blot, Matteo Bassetti, Andrew Conway-Morris, Rosa Reina, Enrique Teran, Candela Sole-Lleonart, Maria Ruiz-Rodríguez, Jordi Rello |
| Abstract |
2017 ESCMID practice guidelines reported safety concerns and weak evidence of benefit supporting use of aerosolized antibiotics in mechanically ventilated patients. Our primary goal was to assess current patterns of aerosolized antibiotic prescription in mechanically ventilated patients. A sequential global survey was performed prior to the release of the ESCMID guidelines, from the 1st of February to the 30th of April 2017, using an electronic platform. Responses were analyzed comparing geographical regions. A total of 410 units responded, with 261 (177 from Europe) being eligible for the full survey. 26.8% of units reported not using aerosolized antibiotics. The two major indications amongst prescribing units were ventilator-associated pneumonia and ventilator-associated tracheobronchitis (74.3% and 49.4%, respectively). 63.6% of units indicated prescription solely in response to multi-drug resistant organisms. In comparison with a survey undertaken in 2014, there was a significant reduction in use of aerosolized antibiotics for prophylaxis (50.6% vs 7.7%, p < 0.05) and colonization (52.9% vs 25.3%, p < 0.05). The large majority of units (91.7%) reported only prescribing in patients with positive pulmonary cultures. Asia appeared to be an outlier, with 53.3% of units reporting empirical use. The most commonly used device was the jet nebulizer. The most commonly prescribed drugs were colistin methanesulfonate (57.6%), colistin base (41.9%) and amikacin (31.4%), although there was considerable heterogeneity across geographical areas. A significant gap exists between ESCMID clinical practice recommendations and the use of aerosolized antibiotics in clinical practice. Our findings indicate an urgent need for high-quality education to bring practice into line with evidence-based guidelines. |
X Demographics
The data shown below were collected from the profiles of 20 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 14 | 70% |
| Brazil | 1 | 5% |
| France | 1 | 5% |
| Venezuela, Bolivarian Republic of | 1 | 5% |
| Turkey | 1 | 5% |
| Unknown | 2 | 10% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 15 | 75% |
| Practitioners (doctors, other healthcare professionals) | 3 | 15% |
| Scientists | 2 | 10% |
Mendeley readers
The data shown below were compiled from readership statistics for 58 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 58 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 12 | 21% |
| Other | 7 | 12% |
| Student > Ph. D. Student | 7 | 12% |
| Student > Postgraduate | 4 | 7% |
| Lecturer | 2 | 3% |
| Other | 6 | 10% |
| Unknown | 20 | 34% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 12 | 21% |
| Pharmacology, Toxicology and Pharmaceutical Science | 7 | 12% |
| Nursing and Health Professions | 6 | 10% |
| Environmental Science | 2 | 3% |
| Biochemistry, Genetics and Molecular Biology | 2 | 3% |
| Other | 5 | 9% |
| Unknown | 24 | 41% |
Attention Score in Context
This research output has an Altmetric Attention Score of 11. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 January 2023.
All research outputs
#3,205,675
of 24,460,744 outputs
Outputs from European Journal of Clinical Microbiology & Infectious Diseases
#236
of 2,901 outputs
Outputs of similar age
#70,853
of 452,633 outputs
Outputs of similar age from European Journal of Clinical Microbiology & Infectious Diseases
#11
of 52 outputs
Altmetric has tracked 24,460,744 research outputs across all sources so far. Compared to these this one has done well and is in the 86th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,901 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.8. This one has done particularly well, scoring higher than 91% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 452,633 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 84% of its contemporaries.
We're also able to compare this research output to 52 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 80% of its contemporaries.