Keywords
nosocomial pneumonia
colistimethate sodium
tobramycin
anti-bacterial agents
colistimethate sodium
tobramycin
anti-bacterial agents
How to Cite
Kuzovlev A.N., Lazarev V.V., Shabanov A.K., Kuzkov V.V., Kitiashvili I.Z., Zybin K.D., Bagin V.A., Kostetskiy I.V., Afukov I.I., Zilbert E.V., Kulakov V.F., Lekmanov A.U., Magomedov M.A., Skripkin Y.V., Yaroshetskiy A.I., Voennov O.V., Emelyanov A.A., Doroginin S.V., Shapovalov K.G. Inhaled antibiotics in intensive care medicine (survey of Russian intensivists). A retrospective observational study. Annals of Critical Care. 2020;(3):88–94. doi:10.21320/1818-474X-2020-3-88-94.
Statistic
Abstract Views: 29
PDF_2020-03_88-94 (Русский) Downloads: 6
HTML_2020-03_88-94 (Русский) Downloads: 1
PDF_2020-03_88-94 (Русский) Downloads: 6
HTML_2020-03_88-94 (Русский) Downloads: 1
Statistic from 21.01.2023
Language
Social Networks
Abstract
Introduction. The prevalence of nosocomial infections in Moscow hospitals is 7.61 %. In conditions of almost total poly- and pan-resistance of nosocomial pneumonia pathogens in intensive care units, the search for alternative methods of antibiotic therapy is urgent. One such alternative is inhaled antibiotics (IA). This publication presents the results of the study “nhalation antibiotics in resuscitation” based on a questionnaire survey of anesthesiologists-resuscitators. The purpose of this study is to analyze the frequency of use of inhaled forms of antibiotics for NP in intensive care patients in hospitals of the Russian Federation.
Materials and methods. This survey was reviewed by two leading specialized specialists, approved on November 25, 2017 by the Committee for Recommendations and Organization of Research of the Federation of Anesthesiologists (http://www.far.org.ru/research/362-ingabx). The survey was conducted on 10.01.2018–30.10.2018.
Results. According to the results of the study data were obtained on the prevalence of the use of IA for the treatment of nosocomial pneumonia (64 % of the respondents); indications (all respondents use Russian national guidelines; 80 % prescribe IA if the current antibiotic therapy regimen is ineffective); drugs used (colisthimetate sodium is used in 52 % of cases, tobramycin — 9 %, amikacin — 24 %, other (acetylcystein antibiotic, gentamicin, cephalosporins of various generations, bacteriophages) — 15 %) and equipment (more than 90 % use mesh-nebulizers), criteria for their cancellation (extremely scattered answers).
Conclusion. The results of the questionnaire allow us to substantiate the advisability of additional randomized controlled trials on this issue.
References
- Яковлев С.В., Суворова М.П., Белобородов В.Б. и др. Распространенность и клиническое значение нозокомиальных инфекций в лечебных учреждениях России: исследование ЭРГИНИ. Антибиотики и химиотерапия. 2016; 61(5, 6): 32–42. [Jakovlev S.V., Suvorova M.P., Beloborodov V.B., et al. Rasprostranennost’ i klinicheskoe znachenie nozokomial’nyh infekcij v lechebnyh uchrezhdenijah Rossii: issledovanie JeRGINI. Antibiotiki i himioterapija. 2016; 61(5, 6): 32–42. (In Russ)]
- Гельфанд Б.Р. Нозокомиальная пневмония у взрослых. Российские национальные рекомендации. М.: МИА, 2016. 176 с. [Gelfand B.R. Nozokomial’naya pnevmoniya u vzroslyh. Rossijskie nacional’nye rekomendacii. М.: MIA, 2016. 176 с. (In Russ)]
- Кузовлев А.Н., Шабанов А.К., Гречко А.В. Нозокомиальный трахебронхит в реаниматологии: проблемы диагностики и лечения. Вестник интенсивной терапии имени А.И. Салтанова. 2018; 1: 43–47. DOI: 10.21320/1818-474X-2019-2-40-47 [Kuzovlev A.N., Shabanov A.K., Grechko A.V. Nozokomial’nyj trahebronhit v reanimatologii: problemy diagnostiki i lechenija. Annals of Intensive Care. 2018; 1: 43–47. (In Russ)]
- Torres A., Niederman M.S., Chastre J., et al. International ERS/ESICM/ESCMID/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia: Guidelines for the management of hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP) of the European Respiratory Society (ERS), European Society of Intensive Care Medicine (ESICM), European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and Asociación Latinoamericana del Tórax (ALAT). Eur. Respir. J. 2017; 50(3): 1700582. DOI: 10.1183/13993003.00582-2017
- Kalil A.C., Metersky M.L., Klompas M., et al. Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin. Infect. Dis. 2016; 63(5): e61–e111. DOI: 10.1093/cid/ciw353
- Spellberg В. The future of antibiotics. Critical Care. 2014; 18(3): 228. DOI: 10.1186/cc13948
- Амелина Е.Л., Чучалин А.Г. Ингаляционный тобрамицин в лечении синегнойной инфекции у больных муковисцидозом. Пульмонология. 2009; 5: 120–126. [Amelina E.L., Chuchalin A.G. Ingaljacionnyj tobramicin v lechenii sinegnojnoj infekcii u bol’nyh mukoviscidozom. Pul’monologija. 2009; 5: 120–126. (In Russ)]
- Rello J., Solé-Lleonart C., Rouby J., et al. Use of Nebulized Antimicrobials for the Treatment of Respiratory Infections in Invasively Mechanically Ventilated Adults: A Position Paper from the European Society of Clinical Microbiology and Infectious Diseases. Clin. Microbiol. Infect. 2017; Apr 13; pii: S1198-743X(17)30219-7. DOI: 10.1016/j.cmi.2017.04.011.
- Montgomery A., Rhomberg P., Abuan T., et al. Potentiation effects of amikacin and fosfomycin against selected amikacin-nonsusceptible Gram-negative respiratory tract pathogens. Antimicrob Agents Chemother. 2014; 58: 3714–9. DOI: 10.1128/AAC.02780-13
- Montgomery A., Vallance S., Abuan T., et al. A randomized double-blind placebo-controlled dose-escalation Phase 1 study of aerosolized amikacin and fosfomycin delivered via the PARI Investigational eFlow® Inline Nebulizer System in mechanically ventilated patients. J. Aerosol. Med. Pulm. Drug Deliv. 2014; 27: 441–8. DOI: 10.1089/jamp.2013.1100
- Hallal A., Cohn S., Namias N., et al. Aerosolized tobramycin in the treatment of ventilator associated pneumonia: a pilot study. Surg. Infect. (Larchmt). 2007; 8: 73–81.
- Bassetti M., Vena A., Russo A., Peghin M. Inhaled Liposomal Antimicrobial Delivery in Lung Infections [published online ahead of print, 2020 Jul 20]. Drugs. 2020. DOI: 10.1007/s40265-020-01359-z
- Кузовлев А.Н., Шабанов А.К., Тюрин И.А. Динамика концентрации ингаляционного тобрамицина в крови и бронхоальвеолярной лаважной жидкости при нозокомиальной пневмонии (предварительное сообщение). Общая реаниматология. 2018; 14(5): 32–37. DOI: 10.15360/1813-9779-2018-5-32-37 [Kuzovlev A.N., Shabanov A.K., Tyurin I.A. Dinamika koncentracii ingalyacionnogo tobramicina v krovi i bronhoal’veolyarnoj lavazhnoj zhidkosti pri nozokomial’noj pnevmonii (predvaritel’noe soobshchenie). Obshchaya reanimatologiya. 2018; 14(5): 32–37. (In Russ)]
- Кузовлев А.Н., Гречко А.В. Ингаляционные антибиотики в реаниматологии: состояние, проблемы и перспективы развития. Общая реаниматология. 2017; 13(5): 69–84. DOI: 10.15360/1813-9779-2017-5-69 [Kuzovlev A.N., Grechko A.V. Ingaljacionnye antibiotiki v reanimatologii: sostojanie, problemy i perspektivy razvitija. Obshhaja reanimatologija. 2017; 13(5): 69–84. (In Russ)]
- Ярошецкий А.И., Резепов Н.А., Мандель И.А. и др. Влияние ингаляции амикацина на эффективность лечения вентилятор-ассоциированной пневмонии и вентилятор-ассоциированного трахеобронхита, вызванных полирезистентной грамотрицательной флорой. Сравнительное исследование. Анестезиология и реаниматология. 2018; 63(1): 61–68. DOI: 10.18821/0201-7563-2018-63-1-61-68 [Yaroshetskiy A.I., Rezepov N.A., Mandel I.A., et al. The effect of amikacin inhalation on the effectiveness of the treatment of ventilator-associated pneumonia and ventilator-associated tracheobronchitis caused by multiple drug resistant gram-negative flora. A comparative study. Anesteziologija i reanimatologija. 2018; 63(1): 61–68. (In Russ)]
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.