Effect of Additional Nebulized Amikacin in Ventilator-Associated Pneumonia Caused by Gram Negative Bacteria

• Status: Completed
• Trial end date: 2018-04-01
• Target enrollment: 0
• Participant gender: All

Summary

The purpose of this study is to determine the cure rate from ventilator-associated pneumonia (VAP) caused by Gram negative bacteria when administering add on nebulized amikacin to intravenous antibiotics compared to intravenous antibiotics alone.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Thammasat University
• Treatments: Amikacin

Criteria

Inclusion Criteria:

• Age >/= 18 years

• On mechanical ventilator more than 7 days

• VAP diagnosis inclusion criteria:

1. new/progressive infiltration of chest radiography

2. 2/3 of the following: 1) fever 2) purulent sputum 3) Wbc > 12,000 cell/mm3 or < 4,000 cell/mm3

• Evidence of gram negative bacilli from sputum gram stain or previous sputum culture within 1 week

Exclusion Criteria:

• History of amikacin allergy

• GFR < 30 mL/min except dialytic patients

• Immunocompromised host: HIV CD4 < 200 cells/mm3, leukemia, lymphoma, received chemotherapy within 3 weeks, Absolute neutrophil count < 500/mm3

• Severe ARDS (P/F ratio < 100)

• Endobronchial obstruction:endobronchial mass, endobronchial stenosis

• Atelectasis

• Severe bronchospasm

• Lung abscess

• Complicated parapneumonic effusion/ Empyema

• Chest trauma

• Uncontrolled extrapulmonary infection(s)

• Received intravenous antibiotic(s) more than 48 hours

• Pregnancy/ Lactation