Aerosolized Antimicrobials for the Management of Bacterial and Fungal Infections

摘要

Hospital-acquired pneumonia (HAP) is a leading cause of death for inpatients and can respond poorly to IV antimicrobials. One factor in treatment failures may be poor penetration of antimicrobials into the lung. Using aerosolized antimicrobials (AA) may generate higher drug concentrations in the lung. This paper is a brief review of this literature. Prevention of HAP with AA is not recommended because of mixed efficacy results and increased bacterial resistance. Alternatively, AA are recommended as adjunctive therapy to treat HAP in selected patients with resistant organisms. Prophylactic aerosolized amphotericin B to prevent fungal pneumonia in immunocompromised patients is not recommended as those clinical trials had mixed results. Attention to pulmonary adverse events and optimal administration technique is required.