具有多重耐药(MDR)革兰氏阴性菌的呼吸机相关性肺炎(VAP)是重症监护病房(ICU)中的常见问题。当作为佐剂添加时,雾化抗生素增强全身性抗生素的功效。
本研究的主要目的是比较VAP患者的临床和细菌学结果,这些患者单独使用静脉内(IV)抗生素和辅助雾化粘菌素(NC)以及IV抗生素治疗。次要目的是研究粘菌素雾化过程中任何不良事件的发生。
这项研究是前瞻性的,随机化,在三级护理教学机构进行的双盲对照研究。
选择98名年龄小于12岁的外科ICU患儿,在心脏手术后因革兰氏阴性菌被诊断为VAP,并随机分为两组。实验组(NC组)在NC的同时给予全身抗生素治疗,而对照组(NS组)给予全身抗生素和雾化生理盐水(NS)。记录了临床和细菌学结果。使用SPSS20.0版软件进行统计分析。使用独立的Studentt检验和卡方检验比较患者特征。
机械通气的持续时间有统计学上的显着减少,与NS组相比,NC组术后ICU和住院时间(P<0.05)。
由于对粘菌素敏感的革兰氏阴性菌,在患有VAP的儿科患者中,雾化粘菌素可以被认为是全身性IV抗生素的辅助药物。
Ventilator-associated pneumonia (VAP) with multidrug-resistant (MDR) gram negative organisms is a common problem in intensive care unit (ICU). Aerosolized antibiotics enhance the efficacy of systemic antibiotics when added as adjuvants.
The primary objective of the study was to compare the clinical and bacteriological outcome of patients with VAP who were administered intravenous (IV) antibiotics alone with those patients who were treated with adjunctive nebulized colistin (NC) along with IV antibiotics. The secondary objective was to study the occurrence of any adverse events during colistin nebulization.
The study was a prospective, randomized, double-blinded controlled study conducted at a tertiary-care teaching institution.
Ninety-eight children from surgical ICU aged less than 12 years who were diagnosed with VAP due to gram negative bacteria following cardiac surgery were chosen and divided randomly into two groups. The experimental group (NC group) was treated with systemic antibiotics along with NC, whereas the control group (NS group) was administered systemic antibiotics with nebulized normal saline (NS). Clinical and bacteriological outcomes were noted. Statistical analysis was done using SPSS Version 20.0 software. The patient characteristics were compared using independent Student\'s t test and Chi-square test.
There was a statistically significant reduction in the duration of mechanical ventilation, postoperative ICU and hospital stay (P < 0.05) in the NC group compared with the NS group.
Aerosolized colistin may be considered as an adjunct to systemic IV antibiotics in pediatric patients with VAP due to gram negative bacteria susceptible to colistin.