Nebulized antibiotics in mechanically ventilated patients: a challenge for translational research from technology to clinical care View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-08-01

AUTHORS

Stephan Ehrmann, Jean Chastre, Patrice Diot, Qin Lu

ABSTRACT

Nebulized antibiotic therapy directly targets airways and lung parenchyma resulting in high local concentrations and potentially lower systemic toxicities. Experimental and clinical studies have provided evidence for elevated lung concentrations and rapid bacterial killing following the administration of nebulized antibiotics during mechanical ventilation. Delivery of high concentrations of antibiotics to infected lung regions is the key to achieving efficient nebulized antibiotic therapy. However, current non-standardized clinical practice, the difficulties with implementing optimal nebulization techniques and the lack of robust clinical data have limited its widespread adoption. The present review summarizes the techniques and clinical constraints for optimal delivery of nebulized antibiotics to lung parenchyma during invasive mechanical ventilation. Pulmonary pharmacokinetics and pharmacodynamics of nebulized antibiotic therapy to treat ventilator-associated pneumonia are discussed and put into perspective. Experimental and clinical pharmacokinetics and pharmacodynamics support the use of nebulized antibiotics. However, its clinical benefits compared to intravenous therapy remain to be proved. Future investigations should focus on continuous improvement of nebulization practices and techniques. Before expanding its clinical use, careful design of large phase III randomized trials implementing adequate therapeutic strategies in targeted populations is required to demonstrate the clinical effectiveness of nebulized antibiotics in terms of patient outcomes and reduction in the emergence of antibiotic resistance. More... »

PAGES

78

References to SciGraph publications

  • 2012-11-13. A randomized trial of 7-day doripenem versus 10-day imipenem-cilastatin for ventilator-associated pneumonia in CRITICAL CARE
  • 2014-12-31. Topical antibiotics as a major contextual hazard toward bacteremia within selective digestive decontamination studies: a meta-analysis in BMC INFECTIOUS DISEASES
  • 2003-05-15. Maximizing aerosol delivery during mechanical ventilation: go with the flow and go slow in INTENSIVE CARE MEDICINE
  • 2013-03-23. Aerosol therapy during mechanical ventilation: an international survey in INTENSIVE CARE MEDICINE
  • 2012-07-19. Pharmacokinetics of inhaled colistimethate sodium (CMS) in mechanically ventilated critically ill patients in INTENSIVE CARE MEDICINE
  • 2014-04-01. Predictors of insufficient amikacin peak concentration in critically ill patients receiving a 25 mg/kg total body weight regimen in INTENSIVE CARE MEDICINE
  • 2015-12-01. Nebulized antibiotics for ventilator-associated pneumonia: a systematic review and meta-analysis in CRITICAL CARE
  • 2009-12-10. Pharmacokinetics and lung delivery of PDDS-aerosolized amikacin (NKTR-061) in intubated and mechanically ventilated patients with nosocomial pneumonia in CRITICAL CARE
  • 2016-03-31. Efficacy and toxicity of aerosolised colistin in ventilator-associated pneumonia: a prospective, randomised trial in ANNALS OF INTENSIVE CARE
  • 2016-07-22. Aerosol delivery with two ventilation modes during mechanical ventilation: a randomized study in ANNALS OF INTENSIVE CARE
  • 2014-06-23. Impact of appropriate antimicrobial treatment on transition from ventilator-associated tracheobronchitis to ventilator-associated pneumonia in CRITICAL CARE
  • 2016-03-08. The use of inhaled antibiotic therapy in the treatment of ventilator-associated pneumonia and tracheobronchitis: a systematic review in BMC PULMONARY MEDICINE
  • 2010-04-16. Nebulized and intravenous colistin in experimental pneumonia caused by Pseudomonas aeruginosa in INTENSIVE CARE MEDICINE
  • 1999-03. Tobramycin penetration into epithelial lining fluid of patients with pneumonia in CLINICAL PHARMACOLOGY & THERAPEUTICS
  • 2011-12-07. BAY41-6551 achieves bactericidal tracheal aspirate amikacin concentrations in mechanically ventilated patients with Gram-negative pneumonia in INTENSIVE CARE MEDICINE
  • 2008-04-30. Comparison of lung tissue concentrations of nebulized ceftazidime in ventilated piglets: ultrasonic versus vibrating plate nebulizers in INTENSIVE CARE MEDICINE
  • 2011-10. Penetration of Anti-Infective Agents into Pulmonary Epithelial Lining Fluid in CLINICAL PHARMACOKINETICS
  • 2006-08-25. Administration of antibiotics via the respiratory tract for the prevention of ICU-acquired pneumonia: a meta-analysis of comparative trials in CRITICAL CARE
  • 2010-04-06. Revisiting the loading dose of amikacin for patients with severe sepsis and septic shock in CRITICAL CARE
  • 2015-11-24. Aerosol therapy in intensive and intermediate care units: prospective observation of 2808 critically ill patients in INTENSIVE CARE MEDICINE
  • 2013-08-19. Trough colistin plasma level is an independent risk factor for nephrotoxicity: a prospective observational cohort study in BMC INFECTIOUS DISEASES
  • 2009-08-04. Nebulized ceftazidime in experimental pneumonia caused by partially resistant Pseudomonas aeruginosa in INTENSIVE CARE MEDICINE
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1186/s13613-017-0301-6

    DOI

    http://dx.doi.org/10.1186/s13613-017-0301-6

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1090939243

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/28766281


    Indexing Status Check whether this publication has been indexed by Scopus and Web Of Science using the SN Indexing Status Tool
    Incoming Citations Browse incoming citations for this publication using opencitations.net

    JSON-LD is the canonical representation for SciGraph data.

    TIP: You can open this SciGraph record using an external JSON-LD service: JSON-LD Playground Google SDTT

    [
      {
        "@context": "https://springernature.github.io/scigraph/jsonld/sgcontext.json", 
        "about": [
          {
            "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/11", 
            "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
            "name": "Medical and Health Sciences", 
            "type": "DefinedTerm"
          }, 
          {
            "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/1102", 
            "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
            "name": "Cardiorespiratory Medicine and Haematology", 
            "type": "DefinedTerm"
          }
        ], 
        "author": [
          {
            "affiliation": {
              "alternateName": "Centre d\u2019\u00e9tudes des Pathologies Respiratoire, INSERM U1100, Facult\u00e9 de M\u00e9decine de Tours, Universit\u00e9 Fran\u00e7ois Rabelais de Tours, Tours, France", 
              "id": "http://www.grid.ac/institutes/grid.12366.30", 
              "name": [
                "M\u00e9decine Intensive R\u00e9animation, R\u00e9seau CRICS-TRIGGERSEP, Centre Hospitalier R\u00e9gional et Universitaire de Tours, Tours, France", 
                "Centre d\u2019\u00e9tudes des Pathologies Respiratoire, INSERM U1100, Facult\u00e9 de M\u00e9decine de Tours, Universit\u00e9 Fran\u00e7ois Rabelais de Tours, Tours, France"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Ehrmann", 
            "givenName": "Stephan", 
            "id": "sg:person.01360153066.67", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01360153066.67"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Service de R\u00e9animation M\u00e9dicale, Institut de Cardiologie, Assistance Publique-H\u00f4pitaux de Paris, Piti\u00e9-Salp\u00eatri\u00e8re Hospital, UPMC (University Pierre and Marie Curie) Paris-6, Paris, France", 
              "id": "http://www.grid.ac/institutes/grid.411439.a", 
              "name": [
                "Service de R\u00e9animation M\u00e9dicale, Institut de Cardiologie, Assistance Publique-H\u00f4pitaux de Paris, Piti\u00e9-Salp\u00eatri\u00e8re Hospital, UPMC (University Pierre and Marie Curie) Paris-6, Paris, France"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Chastre", 
            "givenName": "Jean", 
            "id": "sg:person.0714077601.27", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0714077601.27"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Pneumologie, Centre Hospitalier R\u00e9gional et Universitaire de Tours, Tours, France", 
              "id": "http://www.grid.ac/institutes/grid.411167.4", 
              "name": [
                "Centre d\u2019\u00e9tudes des Pathologies Respiratoire, INSERM U1100, Facult\u00e9 de M\u00e9decine de Tours, Universit\u00e9 Fran\u00e7ois Rabelais de Tours, Tours, France", 
                "Pneumologie, Centre Hospitalier R\u00e9gional et Universitaire de Tours, Tours, France"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Diot", 
            "givenName": "Patrice", 
            "id": "sg:person.0612757774.97", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0612757774.97"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Multidisciplinary Critical Care Unit, Department of Anesthesiology and Critical Care Medicine, Assistance Publique-H\u00f4pitaux de Paris, Piti\u00e9-Salp\u00eatri\u00e8re Hospital, UPMC (University Pierre and Marie Curie) Paris-6, Paris, France", 
              "id": "http://www.grid.ac/institutes/grid.411439.a", 
              "name": [
                "Multidisciplinary Critical Care Unit, Department of Anesthesiology and Critical Care Medicine, Assistance Publique-H\u00f4pitaux de Paris, Piti\u00e9-Salp\u00eatri\u00e8re Hospital, UPMC (University Pierre and Marie Curie) Paris-6, Paris, France"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Lu", 
            "givenName": "Qin", 
            "id": "sg:person.0743200021.09", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0743200021.09"
            ], 
            "type": "Person"
          }
        ], 
        "citation": [
          {
            "id": "sg:pub.10.1007/s00134-009-1605-2", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1033258941", 
              "https://doi.org/10.1007/s00134-009-1605-2"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.2165/11594090-000000000-00000", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1026155057", 
              "https://doi.org/10.2165/11594090-000000000-00000"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1186/cc11862", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1017822371", 
              "https://doi.org/10.1186/cc11862"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1186/s13054-015-0868-y", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1012537230", 
              "https://doi.org/10.1186/s13054-015-0868-y"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1186/s13613-016-0169-x", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1038657449", 
              "https://doi.org/10.1186/s13613-016-0169-x"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1186/1471-2334-13-380", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1048745746", 
              "https://doi.org/10.1186/1471-2334-13-380"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1016/s0009-9236(99)70103-7", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1037539403", 
              "https://doi.org/10.1016/s0009-9236(99)70103-7"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1186/cc13940", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1018084438", 
              "https://doi.org/10.1186/cc13940"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1186/s12879-014-0714-x", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1012057896", 
              "https://doi.org/10.1186/s12879-014-0714-x"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s00134-003-1791-2", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1003903828", 
              "https://doi.org/10.1007/s00134-003-1791-2"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1186/cc5032", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1030595700", 
              "https://doi.org/10.1186/cc5032"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1186/s12890-016-0202-8", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1035517780", 
              "https://doi.org/10.1186/s12890-016-0202-8"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s00134-013-2872-5", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1023404664", 
              "https://doi.org/10.1007/s00134-013-2872-5"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s00134-012-2628-7", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1049470243", 
              "https://doi.org/10.1007/s00134-012-2628-7"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1186/cc8206", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1010862289", 
              "https://doi.org/10.1186/cc8206"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s00134-011-2420-0", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1023392555", 
              "https://doi.org/10.1007/s00134-011-2420-0"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s00134-014-3276-x", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1007041971", 
              "https://doi.org/10.1007/s00134-014-3276-x"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s00134-015-4114-5", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1037533549", 
              "https://doi.org/10.1007/s00134-015-4114-5"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1186/s13613-016-0127-7", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1010088873", 
              "https://doi.org/10.1186/s13613-016-0127-7"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s00134-008-1126-4", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1000713512", 
              "https://doi.org/10.1007/s00134-008-1126-4"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s00134-010-1879-4", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1046735722", 
              "https://doi.org/10.1007/s00134-010-1879-4"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1186/cc8945", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1048025212", 
              "https://doi.org/10.1186/cc8945"
            ], 
            "type": "CreativeWork"
          }
        ], 
        "datePublished": "2017-08-01", 
        "datePublishedReg": "2017-08-01", 
        "description": "Nebulized antibiotic therapy directly targets airways and lung parenchyma resulting in high local concentrations and potentially lower systemic toxicities. Experimental and clinical studies have provided evidence for elevated lung concentrations and rapid bacterial killing following the administration of nebulized antibiotics during mechanical ventilation. Delivery of high concentrations of antibiotics to infected lung regions is the key to achieving efficient nebulized antibiotic therapy. However, current non-standardized clinical practice, the difficulties with implementing optimal nebulization techniques and the lack of robust clinical data have limited its widespread adoption. The present review summarizes the techniques and clinical constraints for optimal delivery of nebulized antibiotics to lung parenchyma during invasive mechanical ventilation. Pulmonary pharmacokinetics and pharmacodynamics of nebulized antibiotic therapy to treat ventilator-associated pneumonia are discussed and put into perspective. Experimental and clinical pharmacokinetics and pharmacodynamics support the use of nebulized antibiotics. However, its clinical benefits compared to intravenous therapy remain to be proved. Future investigations should focus on continuous improvement of nebulization practices and techniques. Before expanding its clinical use, careful design of large phase III randomized trials implementing adequate therapeutic strategies in targeted populations is required to demonstrate the clinical effectiveness of nebulized antibiotics in terms of patient outcomes and reduction in the emergence of antibiotic resistance.", 
        "genre": "article", 
        "id": "sg:pub.10.1186/s13613-017-0301-6", 
        "isAccessibleForFree": true, 
        "isPartOf": [
          {
            "id": "sg:journal.1045300", 
            "issn": [
              "2110-5820"
            ], 
            "name": "Annals of Intensive Care", 
            "publisher": "Springer Nature", 
            "type": "Periodical"
          }, 
          {
            "issueNumber": "1", 
            "type": "PublicationIssue"
          }, 
          {
            "type": "PublicationVolume", 
            "volumeNumber": "7"
          }
        ], 
        "keywords": [
          "nebulized antibiotics", 
          "antibiotic therapy", 
          "mechanical ventilation", 
          "lung parenchyma", 
          "phase III randomized trials", 
          "large phase III randomized trials", 
          "invasive mechanical ventilation", 
          "ventilator-associated pneumonia", 
          "robust clinical data", 
          "adequate therapeutic strategies", 
          "rapid bacterial killing", 
          "lung concentrations", 
          "intravenous therapy", 
          "randomized trials", 
          "clinical benefit", 
          "pulmonary pharmacokinetics", 
          "Clinical Pharmacokinetics", 
          "clinical effectiveness", 
          "patient outcomes", 
          "clinical studies", 
          "clinical data", 
          "low systemic toxicity", 
          "clinical care", 
          "therapeutic strategies", 
          "clinical practice", 
          "systemic toxicity", 
          "therapy", 
          "bacterial killing", 
          "clinical use", 
          "optimal delivery", 
          "translational research", 
          "lung regions", 
          "antibiotics", 
          "antibiotic resistance", 
          "pharmacodynamics", 
          "pharmacokinetics", 
          "clinical constraints", 
          "parenchyma", 
          "present review", 
          "ventilation", 
          "high local concentrations", 
          "future investigations", 
          "delivery", 
          "pneumonia", 
          "airway", 
          "patients", 
          "administration", 
          "trials", 
          "care", 
          "high concentrations", 
          "outcomes", 
          "toxicity", 
          "killing", 
          "concentration", 
          "review", 
          "population", 
          "local concentration", 
          "nebulization technique", 
          "use", 
          "practice", 
          "evidence", 
          "widespread adoption", 
          "study", 
          "benefits", 
          "lack", 
          "reduction", 
          "improvement", 
          "resistance", 
          "technique", 
          "data", 
          "difficulties", 
          "strategies", 
          "effectiveness", 
          "investigation", 
          "challenges", 
          "emergence", 
          "continuous improvement", 
          "region", 
          "research", 
          "perspective", 
          "terms", 
          "adoption", 
          "design", 
          "key", 
          "careful design", 
          "technology", 
          "constraints"
        ], 
        "name": "Nebulized antibiotics in mechanically ventilated patients: a challenge for translational research from technology to clinical care", 
        "pagination": "78", 
        "productId": [
          {
            "name": "dimensions_id", 
            "type": "PropertyValue", 
            "value": [
              "pub.1090939243"
            ]
          }, 
          {
            "name": "doi", 
            "type": "PropertyValue", 
            "value": [
              "10.1186/s13613-017-0301-6"
            ]
          }, 
          {
            "name": "pubmed_id", 
            "type": "PropertyValue", 
            "value": [
              "28766281"
            ]
          }
        ], 
        "sameAs": [
          "https://doi.org/10.1186/s13613-017-0301-6", 
          "https://app.dimensions.ai/details/publication/pub.1090939243"
        ], 
        "sdDataset": "articles", 
        "sdDatePublished": "2022-10-01T06:43", 
        "sdLicense": "https://scigraph.springernature.com/explorer/license/", 
        "sdPublisher": {
          "name": "Springer Nature - SN SciGraph project", 
          "type": "Organization"
        }, 
        "sdSource": "s3://com-springernature-scigraph/baseset/20221001/entities/gbq_results/article/article_734.jsonl", 
        "type": "ScholarlyArticle", 
        "url": "https://doi.org/10.1186/s13613-017-0301-6"
      }
    ]
     

    Download the RDF metadata as:  json-ld nt turtle xml License info

    HOW TO GET THIS DATA PROGRAMMATICALLY:

    JSON-LD is a popular format for linked data which is fully compatible with JSON.

    curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/pub.10.1186/s13613-017-0301-6'

    N-Triples is a line-based linked data format ideal for batch operations.

    curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/pub.10.1186/s13613-017-0301-6'

    Turtle is a human-readable linked data format.

    curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/pub.10.1186/s13613-017-0301-6'

    RDF/XML is a standard XML format for linked data.

    curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1186/s13613-017-0301-6'


     

    This table displays all metadata directly associated to this object as RDF triples.

    266 TRIPLES      21 PREDICATES      134 URIs      104 LITERALS      7 BLANK NODES

    Subject Predicate Object
    1 sg:pub.10.1186/s13613-017-0301-6 schema:about anzsrc-for:11
    2 anzsrc-for:1102
    3 schema:author N8e2e35e194284dec9a09582fa8226464
    4 schema:citation sg:pub.10.1007/s00134-003-1791-2
    5 sg:pub.10.1007/s00134-008-1126-4
    6 sg:pub.10.1007/s00134-009-1605-2
    7 sg:pub.10.1007/s00134-010-1879-4
    8 sg:pub.10.1007/s00134-011-2420-0
    9 sg:pub.10.1007/s00134-012-2628-7
    10 sg:pub.10.1007/s00134-013-2872-5
    11 sg:pub.10.1007/s00134-014-3276-x
    12 sg:pub.10.1007/s00134-015-4114-5
    13 sg:pub.10.1016/s0009-9236(99)70103-7
    14 sg:pub.10.1186/1471-2334-13-380
    15 sg:pub.10.1186/cc11862
    16 sg:pub.10.1186/cc13940
    17 sg:pub.10.1186/cc5032
    18 sg:pub.10.1186/cc8206
    19 sg:pub.10.1186/cc8945
    20 sg:pub.10.1186/s12879-014-0714-x
    21 sg:pub.10.1186/s12890-016-0202-8
    22 sg:pub.10.1186/s13054-015-0868-y
    23 sg:pub.10.1186/s13613-016-0127-7
    24 sg:pub.10.1186/s13613-016-0169-x
    25 sg:pub.10.2165/11594090-000000000-00000
    26 schema:datePublished 2017-08-01
    27 schema:datePublishedReg 2017-08-01
    28 schema:description Nebulized antibiotic therapy directly targets airways and lung parenchyma resulting in high local concentrations and potentially lower systemic toxicities. Experimental and clinical studies have provided evidence for elevated lung concentrations and rapid bacterial killing following the administration of nebulized antibiotics during mechanical ventilation. Delivery of high concentrations of antibiotics to infected lung regions is the key to achieving efficient nebulized antibiotic therapy. However, current non-standardized clinical practice, the difficulties with implementing optimal nebulization techniques and the lack of robust clinical data have limited its widespread adoption. The present review summarizes the techniques and clinical constraints for optimal delivery of nebulized antibiotics to lung parenchyma during invasive mechanical ventilation. Pulmonary pharmacokinetics and pharmacodynamics of nebulized antibiotic therapy to treat ventilator-associated pneumonia are discussed and put into perspective. Experimental and clinical pharmacokinetics and pharmacodynamics support the use of nebulized antibiotics. However, its clinical benefits compared to intravenous therapy remain to be proved. Future investigations should focus on continuous improvement of nebulization practices and techniques. Before expanding its clinical use, careful design of large phase III randomized trials implementing adequate therapeutic strategies in targeted populations is required to demonstrate the clinical effectiveness of nebulized antibiotics in terms of patient outcomes and reduction in the emergence of antibiotic resistance.
    29 schema:genre article
    30 schema:isAccessibleForFree true
    31 schema:isPartOf Nb8a401d5f9d84eeea655d4e6866cb294
    32 Ne3defaf3357348c8b6324aba4667ccb9
    33 sg:journal.1045300
    34 schema:keywords Clinical Pharmacokinetics
    35 adequate therapeutic strategies
    36 administration
    37 adoption
    38 airway
    39 antibiotic resistance
    40 antibiotic therapy
    41 antibiotics
    42 bacterial killing
    43 benefits
    44 care
    45 careful design
    46 challenges
    47 clinical benefit
    48 clinical care
    49 clinical constraints
    50 clinical data
    51 clinical effectiveness
    52 clinical practice
    53 clinical studies
    54 clinical use
    55 concentration
    56 constraints
    57 continuous improvement
    58 data
    59 delivery
    60 design
    61 difficulties
    62 effectiveness
    63 emergence
    64 evidence
    65 future investigations
    66 high concentrations
    67 high local concentrations
    68 improvement
    69 intravenous therapy
    70 invasive mechanical ventilation
    71 investigation
    72 key
    73 killing
    74 lack
    75 large phase III randomized trials
    76 local concentration
    77 low systemic toxicity
    78 lung concentrations
    79 lung parenchyma
    80 lung regions
    81 mechanical ventilation
    82 nebulization technique
    83 nebulized antibiotics
    84 optimal delivery
    85 outcomes
    86 parenchyma
    87 patient outcomes
    88 patients
    89 perspective
    90 pharmacodynamics
    91 pharmacokinetics
    92 phase III randomized trials
    93 pneumonia
    94 population
    95 practice
    96 present review
    97 pulmonary pharmacokinetics
    98 randomized trials
    99 rapid bacterial killing
    100 reduction
    101 region
    102 research
    103 resistance
    104 review
    105 robust clinical data
    106 strategies
    107 study
    108 systemic toxicity
    109 technique
    110 technology
    111 terms
    112 therapeutic strategies
    113 therapy
    114 toxicity
    115 translational research
    116 trials
    117 use
    118 ventilation
    119 ventilator-associated pneumonia
    120 widespread adoption
    121 schema:name Nebulized antibiotics in mechanically ventilated patients: a challenge for translational research from technology to clinical care
    122 schema:pagination 78
    123 schema:productId N21210ca58f174155ad55a8bc168ca2a2
    124 N3c8efdb1699441f29f0f2c9428d1a4c2
    125 Neae05492e60447a9b3809c54825e68bb
    126 schema:sameAs https://app.dimensions.ai/details/publication/pub.1090939243
    127 https://doi.org/10.1186/s13613-017-0301-6
    128 schema:sdDatePublished 2022-10-01T06:43
    129 schema:sdLicense https://scigraph.springernature.com/explorer/license/
    130 schema:sdPublisher Nba8f806aef2b46e399f855cc4ccbb143
    131 schema:url https://doi.org/10.1186/s13613-017-0301-6
    132 sgo:license sg:explorer/license/
    133 sgo:sdDataset articles
    134 rdf:type schema:ScholarlyArticle
    135 N21210ca58f174155ad55a8bc168ca2a2 schema:name dimensions_id
    136 schema:value pub.1090939243
    137 rdf:type schema:PropertyValue
    138 N3c8efdb1699441f29f0f2c9428d1a4c2 schema:name doi
    139 schema:value 10.1186/s13613-017-0301-6
    140 rdf:type schema:PropertyValue
    141 N8e2e35e194284dec9a09582fa8226464 rdf:first sg:person.01360153066.67
    142 rdf:rest Nc05ccd66bb7644c0966a35e6e471573f
    143 Nb6bb3768d150498eae03a25d8bdd78f1 rdf:first sg:person.0743200021.09
    144 rdf:rest rdf:nil
    145 Nb8a401d5f9d84eeea655d4e6866cb294 schema:issueNumber 1
    146 rdf:type schema:PublicationIssue
    147 Nba8f806aef2b46e399f855cc4ccbb143 schema:name Springer Nature - SN SciGraph project
    148 rdf:type schema:Organization
    149 Nc05ccd66bb7644c0966a35e6e471573f rdf:first sg:person.0714077601.27
    150 rdf:rest Neee554e28b0049129e85788aaccea873
    151 Ne3defaf3357348c8b6324aba4667ccb9 schema:volumeNumber 7
    152 rdf:type schema:PublicationVolume
    153 Neae05492e60447a9b3809c54825e68bb schema:name pubmed_id
    154 schema:value 28766281
    155 rdf:type schema:PropertyValue
    156 Neee554e28b0049129e85788aaccea873 rdf:first sg:person.0612757774.97
    157 rdf:rest Nb6bb3768d150498eae03a25d8bdd78f1
    158 anzsrc-for:11 schema:inDefinedTermSet anzsrc-for:
    159 schema:name Medical and Health Sciences
    160 rdf:type schema:DefinedTerm
    161 anzsrc-for:1102 schema:inDefinedTermSet anzsrc-for:
    162 schema:name Cardiorespiratory Medicine and Haematology
    163 rdf:type schema:DefinedTerm
    164 sg:journal.1045300 schema:issn 2110-5820
    165 schema:name Annals of Intensive Care
    166 schema:publisher Springer Nature
    167 rdf:type schema:Periodical
    168 sg:person.01360153066.67 schema:affiliation grid-institutes:grid.12366.30
    169 schema:familyName Ehrmann
    170 schema:givenName Stephan
    171 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01360153066.67
    172 rdf:type schema:Person
    173 sg:person.0612757774.97 schema:affiliation grid-institutes:grid.411167.4
    174 schema:familyName Diot
    175 schema:givenName Patrice
    176 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0612757774.97
    177 rdf:type schema:Person
    178 sg:person.0714077601.27 schema:affiliation grid-institutes:grid.411439.a
    179 schema:familyName Chastre
    180 schema:givenName Jean
    181 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0714077601.27
    182 rdf:type schema:Person
    183 sg:person.0743200021.09 schema:affiliation grid-institutes:grid.411439.a
    184 schema:familyName Lu
    185 schema:givenName Qin
    186 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0743200021.09
    187 rdf:type schema:Person
    188 sg:pub.10.1007/s00134-003-1791-2 schema:sameAs https://app.dimensions.ai/details/publication/pub.1003903828
    189 https://doi.org/10.1007/s00134-003-1791-2
    190 rdf:type schema:CreativeWork
    191 sg:pub.10.1007/s00134-008-1126-4 schema:sameAs https://app.dimensions.ai/details/publication/pub.1000713512
    192 https://doi.org/10.1007/s00134-008-1126-4
    193 rdf:type schema:CreativeWork
    194 sg:pub.10.1007/s00134-009-1605-2 schema:sameAs https://app.dimensions.ai/details/publication/pub.1033258941
    195 https://doi.org/10.1007/s00134-009-1605-2
    196 rdf:type schema:CreativeWork
    197 sg:pub.10.1007/s00134-010-1879-4 schema:sameAs https://app.dimensions.ai/details/publication/pub.1046735722
    198 https://doi.org/10.1007/s00134-010-1879-4
    199 rdf:type schema:CreativeWork
    200 sg:pub.10.1007/s00134-011-2420-0 schema:sameAs https://app.dimensions.ai/details/publication/pub.1023392555
    201 https://doi.org/10.1007/s00134-011-2420-0
    202 rdf:type schema:CreativeWork
    203 sg:pub.10.1007/s00134-012-2628-7 schema:sameAs https://app.dimensions.ai/details/publication/pub.1049470243
    204 https://doi.org/10.1007/s00134-012-2628-7
    205 rdf:type schema:CreativeWork
    206 sg:pub.10.1007/s00134-013-2872-5 schema:sameAs https://app.dimensions.ai/details/publication/pub.1023404664
    207 https://doi.org/10.1007/s00134-013-2872-5
    208 rdf:type schema:CreativeWork
    209 sg:pub.10.1007/s00134-014-3276-x schema:sameAs https://app.dimensions.ai/details/publication/pub.1007041971
    210 https://doi.org/10.1007/s00134-014-3276-x
    211 rdf:type schema:CreativeWork
    212 sg:pub.10.1007/s00134-015-4114-5 schema:sameAs https://app.dimensions.ai/details/publication/pub.1037533549
    213 https://doi.org/10.1007/s00134-015-4114-5
    214 rdf:type schema:CreativeWork
    215 sg:pub.10.1016/s0009-9236(99)70103-7 schema:sameAs https://app.dimensions.ai/details/publication/pub.1037539403
    216 https://doi.org/10.1016/s0009-9236(99)70103-7
    217 rdf:type schema:CreativeWork
    218 sg:pub.10.1186/1471-2334-13-380 schema:sameAs https://app.dimensions.ai/details/publication/pub.1048745746
    219 https://doi.org/10.1186/1471-2334-13-380
    220 rdf:type schema:CreativeWork
    221 sg:pub.10.1186/cc11862 schema:sameAs https://app.dimensions.ai/details/publication/pub.1017822371
    222 https://doi.org/10.1186/cc11862
    223 rdf:type schema:CreativeWork
    224 sg:pub.10.1186/cc13940 schema:sameAs https://app.dimensions.ai/details/publication/pub.1018084438
    225 https://doi.org/10.1186/cc13940
    226 rdf:type schema:CreativeWork
    227 sg:pub.10.1186/cc5032 schema:sameAs https://app.dimensions.ai/details/publication/pub.1030595700
    228 https://doi.org/10.1186/cc5032
    229 rdf:type schema:CreativeWork
    230 sg:pub.10.1186/cc8206 schema:sameAs https://app.dimensions.ai/details/publication/pub.1010862289
    231 https://doi.org/10.1186/cc8206
    232 rdf:type schema:CreativeWork
    233 sg:pub.10.1186/cc8945 schema:sameAs https://app.dimensions.ai/details/publication/pub.1048025212
    234 https://doi.org/10.1186/cc8945
    235 rdf:type schema:CreativeWork
    236 sg:pub.10.1186/s12879-014-0714-x schema:sameAs https://app.dimensions.ai/details/publication/pub.1012057896
    237 https://doi.org/10.1186/s12879-014-0714-x
    238 rdf:type schema:CreativeWork
    239 sg:pub.10.1186/s12890-016-0202-8 schema:sameAs https://app.dimensions.ai/details/publication/pub.1035517780
    240 https://doi.org/10.1186/s12890-016-0202-8
    241 rdf:type schema:CreativeWork
    242 sg:pub.10.1186/s13054-015-0868-y schema:sameAs https://app.dimensions.ai/details/publication/pub.1012537230
    243 https://doi.org/10.1186/s13054-015-0868-y
    244 rdf:type schema:CreativeWork
    245 sg:pub.10.1186/s13613-016-0127-7 schema:sameAs https://app.dimensions.ai/details/publication/pub.1010088873
    246 https://doi.org/10.1186/s13613-016-0127-7
    247 rdf:type schema:CreativeWork
    248 sg:pub.10.1186/s13613-016-0169-x schema:sameAs https://app.dimensions.ai/details/publication/pub.1038657449
    249 https://doi.org/10.1186/s13613-016-0169-x
    250 rdf:type schema:CreativeWork
    251 sg:pub.10.2165/11594090-000000000-00000 schema:sameAs https://app.dimensions.ai/details/publication/pub.1026155057
    252 https://doi.org/10.2165/11594090-000000000-00000
    253 rdf:type schema:CreativeWork
    254 grid-institutes:grid.12366.30 schema:alternateName Centre d’études des Pathologies Respiratoire, INSERM U1100, Faculté de Médecine de Tours, Université François Rabelais de Tours, Tours, France
    255 schema:name Centre d’études des Pathologies Respiratoire, INSERM U1100, Faculté de Médecine de Tours, Université François Rabelais de Tours, Tours, France
    256 Médecine Intensive Réanimation, Réseau CRICS-TRIGGERSEP, Centre Hospitalier Régional et Universitaire de Tours, Tours, France
    257 rdf:type schema:Organization
    258 grid-institutes:grid.411167.4 schema:alternateName Pneumologie, Centre Hospitalier Régional et Universitaire de Tours, Tours, France
    259 schema:name Centre d’études des Pathologies Respiratoire, INSERM U1100, Faculté de Médecine de Tours, Université François Rabelais de Tours, Tours, France
    260 Pneumologie, Centre Hospitalier Régional et Universitaire de Tours, Tours, France
    261 rdf:type schema:Organization
    262 grid-institutes:grid.411439.a schema:alternateName Multidisciplinary Critical Care Unit, Department of Anesthesiology and Critical Care Medicine, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, UPMC (University Pierre and Marie Curie) Paris-6, Paris, France
    263 Service de Réanimation Médicale, Institut de Cardiologie, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, UPMC (University Pierre and Marie Curie) Paris-6, Paris, France
    264 schema:name Multidisciplinary Critical Care Unit, Department of Anesthesiology and Critical Care Medicine, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, UPMC (University Pierre and Marie Curie) Paris-6, Paris, France
    265 Service de Réanimation Médicale, Institut de Cardiologie, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, UPMC (University Pierre and Marie Curie) Paris-6, Paris, France
    266 rdf:type schema:Organization
     




    Preview window. Press ESC to close (or click here)


    ...