2017 Global survey on nebulization of antimicrobial agents in mechanically ventilated patients—SANEME 2 study protocol

Rello, Jordi; Ruiz-Rodriguez, Maria; Zhang, Zhongheng

doi:10.21037/jeccm.2017.04.01

Cited by 2 publications

(1 citation statement)

References 7 publications

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“…considered ineligible. The survey was built on the SANEME 2 study protocol and adapted to the local situation [5]. Questions focused on key aspects of nebulized antimicrobial agents, which were (1) indications, (2) agents used, (3) dosages, and (4) devices and ventilation settings (see supplementary material).…”

Section: Methodsmentioning

confidence: 99%

Heterogeneous approach to nebulization of antimicrobial agents in mechanically ventilated adults in a German tertiary care hospital: a cross-sectional survey

Pfäfflin

Stegemann

Suttorp

et al. 2020

Eur J Clin Microbiol Infect Dis

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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.

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Section: Methodsmentioning

confidence: 99%

Heterogeneous approach to nebulization of antimicrobial agents in mechanically ventilated adults in a German tertiary care hospital: a cross-sectional survey

Pfäfflin

Stegemann

Suttorp

et al. 2020

Eur J Clin Microbiol Infect Dis

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Nebulization of antimicrobial agents in mechanically ventilated adults in 2017: an international cross-sectional survey

Alves

Alp

Koulenti

et al. 2018

Eur J Clin Microbiol Infect Dis

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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.

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2017 Global survey on nebulization of antimicrobial agents in mechanically ventilated patients—SANEME 2 study protocol

Cited by 2 publications

References 7 publications

Heterogeneous approach to nebulization of antimicrobial agents in mechanically ventilated adults in a German tertiary care hospital: a cross-sectional survey

Heterogeneous approach to nebulization of antimicrobial agents in mechanically ventilated adults in a German tertiary care hospital: a cross-sectional survey

Nebulization of antimicrobial agents in mechanically ventilated adults in 2017: an international cross-sectional survey

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