PT  - JOURNAL ARTICLE
AU  - Gerald C Smaldone
TI  - Aerosolized Antibiotics in Mechanically Ventilated Patients
DP  - 2004 Jun 01
TA  - Respiratory Care
PG  - 635--639
VI  - 49
IP  - 6
4099  - http://rc.rcjournal.com/content/49/6/635.short
4100  - http://rc.rcjournal.com/content/49/6/635.full
AB  - Aerosolized antibiotics are potentially useful in intensive care. At State University of New York at Stony Brook we developed a human model of tracheobronchitis in intubated patients. The model provides daily specimens of airway secretions, allowing serial studies of airway inflammation and testing of therapy modes. The presence of local infection is defined by a unique method of quantified sputum collection. Bench models have been developed that illustrate the factors that limit aerosol delivery to intubated patients. With those models clinical trials have defined possible indications for targeted aerosol therapy to patients at risk for deep lung infection. An efficient aerosolized-antibiotics method that delivers the aerosol past the endotracheal tube has been established, and with that method the drug levels in pulmonary secretions exceed by several orders of magnitude the levels expected with intravenous therapy. Potential end points of therapy are being evaluated, including the rate of bacterial resistance and the incidence and definition of deep lung infection.