![]() When reflecting on the impact of all these findings for the everyday clinician, Ehrmann told Healio that implementation is easy. n = 4 0.9%), including four patients who had increased resistance of the expiratory limb filter.įurther, researchers found that an acute kidney injury occurred in 24 patients from the placebo group, compared with only 11 patients from the amikacin group. the placebo group experienced a trial-related serious adverse effect (n = 7 1.7% vs. Notably, a few more patients from the amikacin group vs. placebo, 27%), and tracheobronchitis at randomization (n = 104 amikacin, 32% placebo, 33%). Researchers observed the lower incidence of VAP associated with amikacin persisted among those with tracheobronchial colonization at randomization (n = 185 amikacin, 20% vs. 968 days RR = 0.92 95% CI, 0.81-1.03) compared with the placebo group.Īmong both groups, slightly more patients from the placebo group died in the ICU (n = 112 26% vs. 589 days RR = 0.97 95% CI, 0.92-1.01) and fewer antibiotic days, which captures the total number of systemic antibiotic treatments received each day, per 1,000 ICU days (887 days vs. Patients in the amikacin group also had fewer days with one or more administrations of a systemic antibiotic per 1,000 ICU days (570 days vs. patients from the placebo group (n = 74 18% vs. Researchers also found that fewer patients from the amikacin group experienced an infection-related ventilator-associated complication vs. patients who received placebo (n = 137 33% vs. Similar to the incidence of ventilator-associated pneumonia, fewer patients who received amikacin had a ventilator-associated condition vs. ![]() n = 62 15%), with a difference of 1.5 days (95% CI, 0.6-2.5) in restricted mean survival time to VAP between the two groups.Īmong those who developed VAP, the median time to the first episode following randomization was comparable between the amikacin and placebo groups (10 days vs. Researchers found that more patients who received placebo experienced an episode of VAP by day 28 than patients who received amikacin (n = 95 22% vs. In a multicenter, double-blind, randomized, controlled superiority trial, Ehrmann and colleagues assessed 847 critically ill adults on invasive mechanical ventilation for no less than 72 hours to determine whether inhaled amikacin can prevent VAP for 28 days.Īround 80% of patients assigned to receive amikacin (n = 417) or placebo (n = 430) underwent the full 3-day treatment course, making for a total of 337 patients in the inhaled amikacin group (20 mg per kilogram of ideal body weight once daily) and 355 patients in the placebo group. This means one-third of pneumonia episodes can be prevented,” Stephan Ehrmann, MD, PhD, professor at Centre Hospitalier Régional et Universitaire de Tours, told Healio.ĭata were derived from Ehrmann S, et al. “The reduction in ventilator-associated pneumonia (VAP) incidence was very large more than 30% relative reduction.
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