Title |
Global survey on nebulization of antimicrobial agents in mechanically ventilated patients: a call for international guidelines
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Published in |
Clinical Microbiology and Infection, December 2015
|
DOI | 10.1016/j.cmi.2015.12.016 |
Pubmed ID | |
Authors |
C. Solé-Lleonart, J.A. Roberts, J. Chastre, G. Poulakou, L.B. Palmer, S. Blot, T. Felton, M. Bassetti, C.-E. Luyt, J.M. Pereira, J. Riera, T. Welte, H. Qiu, J.-J. Rouby, J. Rello, the ESGCIP Investigators |
Abstract |
Nebulised antimicrobial agents are increasingly administered for treatment of respiratory infections in mechanically ventilated (MV) patients. A structured online questionnaire assessing the indications, dosages and recent patterns of use for nebulised antimicrobial agents in MV patients was developed. The questionnaire was distributed worldwide and completed by 192 ICUs. The most common indications for using nebulised antimicrobial agent were ventilator-associated tracheobronchitis (VAP; 60/87), ventilator-associated pneumonia (VAT; 58/87) and management of multi-drug resistant Gram negative (58/87) bacilli in the respiratory tract. The most common prescribed nebulised agents were colistin methanesulfonate (CMS) and sulphate (36/87; 41.3% and 24/87; 27.5%), tobramycin (33/87; 37.9%) and amikacin (23/87; 26.4%). CMS, amikacin and tobramycin daily doses for VAP were significantly higher than for VAT (p<0.05). Combination of parenteral and nebulised antibiotics occurred in 36/60 (86%) prescriptions for VAP and 38/58 (66.2%) of prescriptions for VAT. In summary, the use of nebulised antimicrobial agents in MV patients is common. There is marked heterogeneity in clinical practice with significantly different in use between patients with VAP and VAT. Randomised controlled clinical trials and international guidance on indications, dosing and antibiotic combinations to improve clinical outcomes are urgently required. |
X Demographics
Geographical breakdown
Country | Count | As % |
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Spain | 2 | 50% |
France | 1 | 25% |
Unknown | 1 | 25% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Practitioners (doctors, other healthcare professionals) | 2 | 50% |
Members of the public | 1 | 25% |
Scientists | 1 | 25% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Australia | 1 | 1% |
Unknown | 81 | 99% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 13 | 16% |
Student > Postgraduate | 11 | 13% |
Other | 10 | 12% |
Student > Master | 8 | 10% |
Student > Ph. D. Student | 7 | 9% |
Other | 16 | 20% |
Unknown | 17 | 21% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 31 | 38% |
Pharmacology, Toxicology and Pharmaceutical Science | 9 | 11% |
Immunology and Microbiology | 7 | 9% |
Nursing and Health Professions | 6 | 7% |
Agricultural and Biological Sciences | 3 | 4% |
Other | 9 | 11% |
Unknown | 17 | 21% |