Aerosolized Amikacin as Adjunctive Therapy of Ventilator-associated Pneumonia Caused by Mu

Aerosolized Amikacin as Adjunctive Therapy of Ventilator-associated Pneumonia Caused by Multidrug-resistant Gram-negative Bacteria: A Single-center Randomized Controlled Trial

Chang Liu;Yu-Ting Zhang;Zhi-Yong Peng;Qing Zhou;Bo Hu;Hui Zhou;Jian-Guo Li

【期刊名称】《中华医学杂志（英文版）》 【年(卷),期】2017(130)010

【摘要】Background:Aerosolized amikacin (AA) is a current option for the management of ventilator-associated pneumonia (VAP) caused by multidrug-resistant Gram-negative bacteria (MDR-GNB),as it is reported that AA could increase the alveolar level of the drug without increasing systemic toxicity.This study aimed to evaluate the efficacy and safety of AA as an adjunctive therapy for VAP caused by MDR-GNB.Methods:In this single-center,double-blind study conducted in a 36-bed general Intensive Care Unit (ICU) in a tertiary hospital from June 2014 to June 2016,52 ICU patients with confirmed MDR-GNB VAP were randomized to two groups (AA group,n =27 and placebo group,n =25).Amikacin (400 mg,q8h) or saline placebo (4 ml,q8h) was aerosolized for 7 days.The attending physician determined the administration of systemic antibiotics for VAP.Patients were followed up for 28 days.Bacteriological eradication,clinical pulmonary infection score (CPIS),and serum creatinine were assessed on day 7 of therapy.New resistance to