Comparative Study between Combined Intravenous and Nebulized Amikacin versus Intravenous Amikacin Alone for Treatment of Ventilator Associated Pneumonia

Document Type : Original Article

Authors

1 Department of Anesthesia and Intensive Care, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

2 Department of Pulmonology, Zulekha Hospital, Dubai, United Arab Emirates

3 Department of Internal Medicine, Zulekha Hospital, Dubai, United Arab Emirates

4 Department of Critical Care, Zulekha Hospital, Dubai, United Arab Emirates

Abstract

Background: Ventilator-associated pneumonia [VAP] is a type of infection affecting the lower part of the respiratory system related to the intubation of trachea.
Patients and methods: An observational randomized prospective study approved by the ethical committee of Mustasharak Hospital, Saudi Arabia, and was conducted in the period from June 2021 to May 2022. Patients were randomly categorized into two primary groups using a randomized and computer-generated table. The first group [group NI; n=31] received intravenous and nebulized amikacin, while the second group [group [I]; n=31] and only received intravenous amikacin.
Result: Pseudomonas infection accounted for about 65% of patients in group NI, and 40% in group I. Klebsiella infection was 30% in group NI, and 25% in group I. Acinetobacter infection was approximately 15% in group NI and 40% in group I. The Clinical Pulmonary Infection [CPI] score for group NI was ≤ 6 in 73% of patients. In group I, the CPI score was ≤ 6 in 54%. Oxygenation within Group NI significantly improved before, and after treatment [p 0.005]. However, in group I, no change was discovered [p 0.209]. Creatinine level was significantly high in group I after treatment.
Conclusion: Nebulized amikacin is considered a safe and effective treatment option for VAP.

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