Aerosolized Ceftazidime for Prevention of Ventilator-Associated Pneumonia and Drug Effects on the Proinflammatory Response in Critically Ill Trauma Patients
| Autor: | Timothy C. Fabian, Martin A. Croce, G. Christopher Wood, Scott D. Hanes, Vanessa L. Herring, Bradley A. Boucher |
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| Rok vydání: | 2002 |
| Předmět: |
Adult
Male medicine.medical_specialty Critical Illness Ceftazidime Placebo law.invention Hospitals University Double-Blind Method Trauma Centers law medicine Humans Pharmacology (medical) Prospective Studies Adverse effect Antibacterial agent Aerosols medicine.diagnostic_test business.industry Ventilator-associated pneumonia Pneumonia Middle Aged medicine.disease Respiration Artificial Intensive care unit Anti-Bacterial Agents Surgery Bronchoalveolar lavage Anesthesia Cytokines Wounds and Injuries Female business Bronchoalveolar Lavage Fluid medicine.drug |
| Zdroj: | Pharmacotherapy. 22:972-982 |
| ISSN: | 0277-0008 |
| DOI: | 10.1592/phco.22.12.972.33596 |
| Popis: | Study Objectives. To evaluate the safety and efficacy of aerosolized ceftazidime for prevention of ventilator-associated pneumonia (VAP) and to evaluate the effects of the drug on the proinflammatory response. Design. Prospective, randomized, double-blind, placebo-controlled clinical trial. Setting. University teaching hospital. Patients. Forty critically ill trauma patients at high risk for VAP. Intervention. Within 48 hours of admission to the intensive care unit (ICU), patients were randomly assigned to receive aerosolized ceftazidime 250 mg every 12 hours or placebo (normal saline) for up to 7 days. Bronchoalveolar concentrations of tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6, and IL-8 were determined at baseline and the end of therapy (days 4–7). Measurements and Main Results. The frequency of VAP in patients receiving aerosolized ceftazidime was 73% lower than that in patients receiving placebo at ICU day 14 (15% vs 55%, p=0.021), and 54% lower for the entire ICU stay (30% vs 65%, p=0.022). No clinically significant changes in bacterial culture and sensitivity patterns were observed. No adverse events from aerosolized ceftazidime were reported. Pulmonary TNF-α, IL-1β, and IL-8 concentrations were attenuated in the ceftazidime group compared with those in the placebo group (p |
| Databáze: | OpenAIRE |
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