The IASIS, INHALE and VAPORISE trials. Reasons for a triple failure: Study design, aminoglycosides dosing and technique of nebulisation.
(2020) Anaesthesia, critical care & pain medicine — Vol. 39, n° 2, p. 179-183 (2020)
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- Animal studies demonstrate that nebulised aminoglycosides and colimycin (polymyxin E) deliver higher antibiotic concentrations and greater bactericidal activity in the lung parenchyma infected by both sensitive and multidrug-resistant (MDR) Gramnegative bacteria (GNB) [1]. However, superiority of nebulised over intravenous (IV) aminoglycosides and colimycin in patients with ventilator-associated pneumonia (VAP) remains to be demonstrated. Clinical studies are sparse, heterogeneous in terms of aims and methods, and have enrolled a limited number of patients. As a consequence, recommendations from American and European academic societies for using nebulised antibiotics are limited, based on a weak level-of-evidence and sometimes divergent.[...]
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Rouby, J.-J., Monsel, A., Leone, M., Mimoz, O., Laterre, P.-F., & Pugin, J. (2020). The IASIS, INHALE and VAPORISE trials. Reasons for a triple failure: Study design, aminoglycosides dosing and technique of nebulisation. Anaesthesia, critical care & pain medicine, 39(2), 179-183. https://doi.org/10.1016/j.accpm.2020.03.007 (Original work published 2020)