Aerosolized antibiotics and ventilator-associated tracheobronchitis in the intensive care unit.

1. Aerosolized antibiotics and ventilator-associated tracheobronchitis in the intensive care unit. Palmer-Lucy-B, Smaldone-Gerald-C, Chen-John-J, Baram-Daniel, Duan- Tao, Monteforte-Melinda, Varela-Marie, Tempone-Ann-K, O-Riordan- Thomas, Daroowalla-Feroza, Richman-Paul.
Critical care medicine, {Crit-Care-Med}, Jul 2008, vol. 36, no. 7, p. 2008-13, ISSN: 1530-0293.

CONTEXT: In critically ill intubated patients, signs of respiratory infection often persist despite treatment with potent systemic antibiotics. OBJECTIVE: The purpose of this study was to determine whether aerosolized antibiotics, which achieve high drug concentrations in the target organ, would more effectively treat respiratory infection and decrease the need for systemic antibiotics. DESIGN: Double-blind, randomized, placebo-controlled study performed from 2003 through 2004.

SETTING: The medical and surgical intensive care units of a university hospital.

PATIENTS: Critically ill intubated patients were randomized if: 1) > or = 18 yrs of age, intubated for a minimum of 3 days, and expected to survive at least 14 days; and 2) had ventilator-associated tracheobronchitis defined as the production of purulent secretions (> or = 2 mL during 4 hrs) with organism(s) on Gram stain. Of 104 patients monitored, 43 consented for treatment and completed the study. No patients were withdrawn from the study for adverse events.