الفهرس 
A Prospective, controlled study to evaluate the safety and efficacy of nebulized amikacin as adjunctive therapy in hospital acquired and ventilator associated bacterial pneumonia in surgical ICUs
CONTENTSOnly 14 pages are availabe for public view
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Abstract
Background: Ventilator-associated pneumonia (VAP) and Hospital acquired pneumonia (HAP) are associated with high rates of morbidity and mortality, which are even greater when appropriate therapy is delayed. It is also associated with a resource utilization load due to the over use of carbapenems for prolonged duration. Nosocomial pneumonia is one of the major infections with multi-drug resistant (MDR) pathogens especially gram negative bacilli (i.e klebsiella and pseudomonas). This is mainly due to sub therapeutic antibiotic concentrations in the lung requiring longer duration of therapy, thus selecting resistant bacteria. Nebulized antibiotics are often administered to treat this type of infections, but strategies are not standardized and may not be ideal. Objective: Current studies indicate that nebulized antibiotics offer high local concentrations with fast clearance and low systemic exposure which will consequently increase efficacy and decrease toxicity. Preliminary clinical studies reveal that aerosolized delivery of antibiotics is well tolerated and active, when combined with intravenous antibiotics. Our goal in this study is to evaluate the efficacy and safety of nebulized amikacin compared to intravenous amikacin in patients with HAP and VAP caused by MDR gram negative bacilli post open heart surgeries. These patients are at higher risk of pneumonia and nephrotoxicity from nephrotoxic drugs like aminoglycosides due to the nature of the operation