Abstract | STUDY OBJECTIVES: DESIGN: Prospective, randomized, double-blind, placebo-controlled clinical trial. SETTING: University teaching hospital. PATIENTS: MEASUREMENTS AND MAIN RESULTS: The frequency of VAP in patients receiving aerosolized ceftazidime was 73% lower than that in patients receiving placebo at ICU day 14 (15% vs 55%, p = 0.021), and 54% lower for the entire ICU stay (30% vs 65%, p = 0.022). No clinically significant changes in bacterial culture and sensitivity patterns were observed. No adverse events from aerosolized ceftazidime were reported. Pulmonary TNF-alpha, IL-beta, and IL-8 concentrations were attenuated in the ceftazidime group compared with those in the placebo group (p < 0.001, p = 0.02, and p = 0.003). The frequency of VAP was related directly to changes in TNF-alpha and IL-beta (p < 0.001, p = 0.02). CONCLUSIONS: Aerosolized ceftazidime decreased the frequency of VAP in critically ill trauma patients, without adversely affecting ICU flora. Aerosolized ceftazidime also may attenuate the proinflammatory response in the lung.
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Authors | G Christopher Wood, Bradley A Boucher, Martin A Croce, Scott D Hanes, Vanessa L Herring, Timothy C Fabian |
Journal | Pharmacotherapy
(Pharmacotherapy)
Vol. 22
Issue 8
Pg. 972-82
(Aug 2002)
ISSN: 0277-0008 [Print] United States |
PMID | 12173800
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Aerosols
- Anti-Bacterial Agents
- Cytokines
- Ceftazidime
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Topics |
- Adult
- Aerosols
- Anti-Bacterial Agents
(pharmacology, therapeutic use)
- Bronchoalveolar Lavage Fluid
(chemistry)
- Ceftazidime
(pharmacology, therapeutic use)
- Critical Illness
- Cytokines
(drug effects, metabolism)
- Double-Blind Method
- Female
- Hospitals, University
- Humans
- Male
- Middle Aged
- Pneumonia
(complications, metabolism, prevention & control)
- Prospective Studies
- Respiration, Artificial
(adverse effects)
- Trauma Centers
- Wounds and Injuries
(complications, drug therapy, metabolism)
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