Nebulized ceftazidime in experimental pneumonia caused by partially resistant Pseudomonas aeruginosa

Ferrari, Fábio; Lü, Qin; Girardi, Cassio; Petitjean, Olivier; Marquette, Charles-Hugo; Wallet, Frédéric; Rouby, Jean‐Jacques

doi:10.1007/s00134-009-1605-2

Cited by 48 publications

(47 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…15 At that time, the fact that no reliable nebulizer was available hampered the development of inhaled antibiotic administration. Since then, many animal [24][25][26][27][28][29][30] and clinical [31][32][33][34][35][36][37][38][39][40][41] studies have investigated both the pharmacodynamics and pharmacokinetics of different categories of antibiotics and compared the bactericidal effect of aerosolized antibiotics with that of intravenous antibiotics. Notably, however, the FDA only cleared the use of inhaled tobramycin for cystic fibrosis in 1997.…”

Section: History Of Inhaled Antibioticsmentioning

confidence: 99%

“…54 The particle size of inhaled antibiotics can be adjusted by changing the diameter of tapered holes on the plate. 28 The advantages and disadvantages of most common commercially available delivery systems are summarized in Table 1.…”

Section: Delivery Systemsmentioning

confidence: 99%

“…In practice, it is possible to achieve similar serum concentrations of antibiotics in patients with dense pneumonias regardless of whether the drugs are given intravenously or via the airways. 28,61 Paradoxically then, this means that treating patients with both intravenous and aerosolized antibiotics could theoretically potentiate risk for adverse drug events by effectively doubling drug delivery to the serum. Some investigators therefore suggest using aerosolized antibiotics as a replacement for rather than as an adjunct to intravenous antibiotics.…”

Section: Con: Aerosolized Antibiotics Should Not Be Used To Treat Venmentioning

confidence: 99%

See 2 more Smart Citations

Should Aerosolized Antibiotics Be Used to Treat Ventilator-Associated Pneumonia?

Zhang,

Berra,

Klompas

2016

Respir Care

View full text Add to dashboard Cite

In patients with ventilator-associated pneumonia, systemic use of antibiotics is the cornerstone of medical management. Supplemental use of aerosolized antibiotics with intravenous antibiotics in both experimental and clinical studies has been shown to have the following pharmacologic benefits: (1) aerosolized antibiotics reach the infected lung parenchyma without crossing the pulmonary alveolar capillary barrier; (2) aerosolized antibiotics increase anti-bacterial efficacy through increased local antibiotic concentration; and (3) aerosolized antibiotics decrease systemic toxicity. These benefits may be particularly beneficial to treat pneumonia caused by multidrug-resistant pathogens. Clinical data on the benefits of aerosolized antibiotics are more limited. Studies to date have not clearly shown improvements in time to extubation, mortality, or other patient-centered outcomes. At present, amikacin, colistin, and ceftazidime are the most frequently used and studied aerosolized antibiotics. This review summarizes the characteristics of aerosolized antibiotics, reviews the advantages and disadvantages of using aerosolized antibiotics, and calls for future investigations based on animal study data.

show abstract

Section: History Of Inhaled Antibioticsmentioning

confidence: 99%

Section: Delivery Systemsmentioning

confidence: 99%

Section: Con: Aerosolized Antibiotics Should Not Be Used To Treat Venmentioning

confidence: 99%

See 1 more Smart Citation

Should Aerosolized Antibiotics Be Used to Treat Ventilator-Associated Pneumonia?

Zhang,

Berra,

Klompas

2016

Respir Care

View full text Add to dashboard Cite

show abstract

“…45 Currently, the understanding of technical conditions regulating lung deposition 46 and numerous technological innovations 47 have increased lung deposition up to 30-60% of the antibiotic dose deposited in the nebulizer. 28,38,41,42,48 Mechanisms by which the antibiotic dose delivered to the distal lung is lower than the dose of antibiotic deposited in the nebulizer are summarized in figure 4. Six critical factors influence lung deposition of nebulized antibiotics during mechanical ventilation: aerosol particle size, type of nebulizer, physical characteristics of the carrying gas, respiratory settings, bronchopneumonia severity, and lung aeration.…”

Section: Factors Influencing Lung Deposition Of Aerosolized Antibioticsmentioning

confidence: 99%

“…56,57 Particle size depends on the diameter of tapered holes, which can be changed by the manufacturer. Although they seem to be slightly inferior to ultrasonic nebulizers, 41 vibrating plate nebulizers have several potential advantages over ultrasonic nebulizers 46,47 : retention in the nebulizer is negligible; the temperature in the reservoir does not increase, minimizing the risk of oxygen desaturation; aerosol generation can be synchronized with inspiration 48 ; and the aerosol can be delivered through an intratracheal catheter inserted in a flexible bronchoscope. 58 They increased the efficiency of aerosol delivery to 40-60%.…”

Section: Type Of Nebulizers and Positioningmentioning

confidence: 99%

Aerosolized Antibiotics for Ventilator-associated Pneumonia

Rouby¹,

Bouhemad

Monsel

et al. 2012

Anesthesiology

Self Cite

View full text Add to dashboard Cite

The aim of this review is to perform a critical analysis of experimental studies on aerosolized antibiotics and draw lessons for clinical use in patients with ventilator-associated pneumonia. Ultrasonic or vibrating plate nebulizers should be preferred to jet nebulizers. During the nebulization period, specific ventilator settings aimed at decreasing flow turbulence should be used, and discoordination with the ventilator should be avoided. The appropriate dose of aerosolized antibiotic can be determined as the intravenous dose plus extrapulmonary deposition. If these conditions are strictly respected, then high lung tissue deposition associated with rapid and efficient bacterial killing can be expected. For aerosolized aminoglycosides and cephalosporins, a decrease in systemic exposure leading to reduced toxicity is not proven by experimental studies. Aerosolized colistin, however, does not easily cross the alveolar-capillary membrane even in the presence of severe lung infection, and high doses can be delivered by nebulization without significant systemic exposure. V ENTILATOR-ASSOCIATED pneumonia frequently complicates the clinical course of patients admitted to intensive care units for multiorgan failure.1,2 Its incidence may be as high as 28% in patients on mechanical ventilation for more than 48 h and 70% in patients with acute lung injury or acute respiratory distress syndrome.3 It prolongs the duration of stay in the intensive care unit, increases costs, 4 and represents the main reason for the prescription of antibiotics in critically ill patients. 5 Associated mortality ranges between 20 and 80% and seem far greater than the mortality resulting from other nosocomial infections.6,7 Causative microorganisms such as Pseudomonas aeruginosa or Acinetobacter baumannii specifically increase mortality.8 Early intravenous administration of appropriate antibiotics is considered as a prerequisite for an efficient treatment of ventilator-associated pneumonia, and bacteriological identification of causative microorganisms is the only way to limit the unnecessary use of antibiotics in the intensive care unit.7 Lung penetration of intravenous antibiotics is, however, often limited; despite appropriate initial antibiotics administration, treatment failure is not infrequent, leading to increased dosage, risk of systemic toxicity, and prolongation of administration. Inappropriate antibiotic concentration at the site of infection and increased antibiotic exposure within the intensive care unit represent important risk factors for development of ventilator-associated pneumonia with resistant organisms. 9,10 Aerosolized antibiotics could represent an attractive alternative to intravenous antibiotics with numerous potential advantages. Reaching the deep lung through the tracheobronchial tree should allow a better control of the main source of parenchymal infection, bronchial colonization.

show abstract

Examination, Therapeutics, and Monitoring of the Respiratory System

Wilkins,

Lascola,

Wong

et al. 2024

Equine Neonatal Medicine

View full text Add to dashboard Cite

Nebulized ceftazidime in experimental pneumonia caused by partially resistant Pseudomonas aeruginosa

Abstract: Nebulized ceftazidime provides more efficient bacterial killing in ventilated piglets with pneumonia caused by Pseudomonas aeruginosa with impaired sensitivity to ceftazidime.

Cited by 48 publications

References 37 publications

Should Aerosolized Antibiotics Be Used to Treat Ventilator-Associated Pneumonia?

Should Aerosolized Antibiotics Be Used to Treat Ventilator-Associated Pneumonia?

Aerosolized Antibiotics for Ventilator-associated Pneumonia

Examination, Therapeutics, and Monitoring of the Respiratory System

Contact Info

Product

Resources

About