INNOVATION IN THE TREATMENT OF VAP (VENTILATOR-ASSOCIATED PNEUMONIA): THE ROLE OF INHALED ANTIBIOTICS

• DOI: https://doi.org/10.22533/at.ed.1594602426066

• Palavras-chave: Pneumonia Associated with Mechanical Ventilation; Inhaled Antibiotic; Amikacin.

• Keywords: Pneumonia Associated with Mechanical Ventilation; Inhaled Antibiotic; Amikacin.

• Abstract:

  Objective: To discuss the effectiveness of using inhaled antibiotics to prevent pneumonia associated with mechanical ventilation. Methodology: The searches were conducted in the PubMed Central (PMC) database, using a combination of terms related to the condition of interest and the treatments investigated, resulting in 58 articles, of which 16 were selected for this work. Review: Several contemporary studies have explored the efficacy and safety of inhaled antibiotics. Currently, the Food and Drug Administration (FDA) has approved only four inhaled antibiotics, each with specific indications. Amikacin is indicated to treat lung disease caused by the Mycobacterium avium complex, while Aztreonam, Colistin, and Tobramycin are used for infections in patients with cystic fibrosis. However, the efficacy of drug delivery to the lungs can be compromised by inadequately sized particles that do not reach the lower airways. Final Considerations: The use of inhaled antibiotics in the prevention of ventilator-associated pneumonia has limited efficacy, with exceptions in specific subgroups, such as patients treated with aerosolized Colistin. On the other hand, inhaled amikacin shows no significant impact on survival compared to controls, indicating variability in the pulmonary distribution of the drug. Due to these limitations and uncertainties in efficacy and risks of adverse effects, recommendations for the use of these antibiotics are limited.