Aerosolized tobramycin in the treatment of ventilator-associated pneumonia: A pilot study

Ali Hallal, Stephen M. Cohn, Nicholas Namias, Fahim Habib, Gio Baracco, Ronald J. Manning, Bruce Crookes, Carl I. Schulman

Research output: Contribution to journalArticlepeer-review

58 Scopus citations

Abstract

Objective: To evaluate the efficacy and safety of inhaled tobramycin (TOBI) in the treatment of ventilator-associated pneumonia (VAP) in a randomized, double-blind pilot study. Patients and Methods: Ten patients from a cohort of 108 mechanically ventilated patients with documented clinical and bacteriological evidence of VAP caused by Pseudomonas aeruginosa or Acinetobacter spp. in the surgical and trauma intensive care units of a university teaching hospital were randomized to receive either TOBI (n = 5) or intravenous tobramycin (TOBRA; n = 5). The two groups were similar in their Acute Physiology and Chronic Health Evaluation (APACHE) score, Clinical Pulmonary Infection Score (CPIS), and Multiple Organ Dysfunction Score (MODS) prior to randomization. The primary outcome measure was resolution of pneumonia. The CPIS and MODS were used as objective indicators of clinical progress. Results: All TOBI patients had clinical resolution of VAP. Two TOBRA patients were considered failures. One had deterioration in MODS, and the other had doubling of his serum creatinine concentration. The patients treated with TOBI may have had more ventilator-free days than those receiving TOBRA, but the difference was not statistically significant owing to the small sample size (24 ± 3 vs. 14 ± 13 days; p = 0.12). Conclusion: Aerosolized tobramycin for the treatment of VAP appeared safe and effective in this pilot study. A larger study is warranted to determine if aerosolized tobramycin will lead to better outcomes than intravenous tobramycin when used for the treatment of VAP.

Original languageEnglish (US)
Pages (from-to)73-81
Number of pages9
JournalSurgical infections
Volume8
Issue number1
DOIs
StatePublished - Feb 2007

ASJC Scopus subject areas

  • Surgery
  • Microbiology (medical)
  • Infectious Diseases

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