Inhaled ceftazidime and amikacin versus inhaled colistin in the treatment of gram negative ventilator associated pneumonia
نویسندگان
چکیده
Methods This prospective randomized controlled study was carried out on 60 mechanically ventilated patients with gram negative VAP. Inclusion criteria: Adult mechanically ventilated patients diagnosed to have Gram negative VAP confirmed:· Radiologically (new chest xray infiltrate). · Microbiologically (positive culture from aspirate of endotracheal tube (ETT). · Clinically (fever, leukocytosis and increased bronchial secretion). CPIS scoring >6. Exclusion criteria: · Severe renal impairment, The patients included in the study were equally randomized to enter one of 3 groups; group A, group B or group C. · Group (A) 20 patients: nebulized ceftazidime (15 mg. kg. 3 h) plus nebulized amikacin (25 mg·kg·d) in addition to conventional IV antibiotics. · Group (B) 20 patients: nebulized Colistin (1million IU every 8h) in addition to conventional IV antibiotics. · Group (C) 20 patients: conventional IV antibiotics. In all groups A,B and C, treatment was continued for five days followed by ETT aspirate. Interpretation of culture results: Clearance: no growth. Resistance: persistent pathogen. Super infection: eradication of previous pathogen with developing of another pathogen. Resistance and super infection: persistent responsible pathogen with developing of another pathogen.
منابع مشابه
Nebulized colistin for treatment of ventilator-associated pneumonia caused by multidrug-resistant Gram-negative bacteria: we still need to straighten out the dose!
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