Aerosolized tobramycin for Pseudomonas aeruginosa ventilator-associated pneumonia in patients with acute respiratory distress syndrome
| Autor: | Takahiro Tashiro, Hidenobu Kamohara, Katsuyuki Sagishima, Susumu Hirosako, Yohei Migiyama, Hirotsugu Kohrogi, Emi Migiyama, Kentaro Tokunaga, Yoshihiro Kinoshita |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine ARDS medicine.disease_cause law.invention Cohort Studies Hospitals University 03 medical and health sciences 0302 clinical medicine law Administration Inhalation medicine Tobramycin Humans Pseudomonas Infections Pharmacology (medical) In patient Aerosolization Aged Retrospective Studies Aerosols Aged 80 and over Respiratory Distress Syndrome business.industry Pseudomonas aeruginosa Biochemistry (medical) Ventilator-associated pneumonia Pneumonia Ventilator-Associated 030208 emergency & critical care medicine Middle Aged medicine.disease Intensive care unit Anti-Bacterial Agents respiratory tract diseases Intensive Care Units Pneumonia Treatment Outcome 030228 respiratory system Anesthesia Female business medicine.drug |
| Zdroj: | Pulmonary Pharmacology & Therapeutics. 45:142-147 |
| ISSN: | 1094-5539 |
| Popis: | Ventilator-associated pneumonia (VAP) due to Pseudomonas aeruginosa has a high mortality and recurrence rate, especially in patients with acute respiratory distress syndrome (ARDS). Therefore, new therapeutic strategies against severe pneumonia are needed. This study evaluated the efficacy of aerosolized tobramycin for P. aeruginosa VAP in ARDS patients.A retrospective analysis was performed on patients who developed VAP caused by P. aeruginosa during the course of ARDS at the intensive care unit (ICU) of Kumamoto University Hospital. Aerosolized tobramycin inhalation solution (TIS) 240 mg was administered daily for 14 days in addition to systemic antibiotics.A total of 44 patients (TIS group, n = 22; control group, n = 22) were included in the analysis. No significant differences were found between the two groups in terms of clinical characteristics, including acute physiology and chronic health evaluation II score upon ICU admission. The TIS group had significantly lower recurrence of P. aeruginosa VAP (22.7% vs. 52.4%, P = 0.04) and ICU mortality (22.7% vs. 63.6%, P 0.01) than the control group. Bacterial concentration in tracheal aspirate (mean log 10 cfu/mL ± SD on days 2-5: 1.2 ± 1.3 vs. 5.0 ± 2.3, P 0.01) decreased more rapidly and markedly in the TIS group compared with the control group.Aerosolized tobramycin was an effective therapeutic strategy for P. aeruginosa VAP patients with ARDS. |
| Databáze: | OpenAIRE |
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