Inhaled Amikacin for the Prevention of VAP
In a multicenter, double-blind, randomized controlled trial involving critically ill adults undergoing mechanical ventilation for over 72 hours, patients were administered either inhaled amikacin (20 mg/kg ideal body weight daily) or a placebo for three days. The study aimed to determine the efficacy of preventive inhaled antibiotics in reducing ventilator-associated pneumonia.
Out of the 847 patients analyzed, 15% in the amikacin group and 22% in the placebo group developed ventilator-associated pneumonia within 28 days. The amikacin group showed a significant reduction in the incidence of pneumonia with a difference in restricted mean survival time of 1.5 days (P=0.004). Furthermore, the amikacin group had fewer infection-related ventilator complications compared to the placebo group. The research concludes that a 3-day course of inhaled amikacin can decrease the occurrence of ventilator-associated pneumonia in patients ventilated for at least three days.