Back

Prophylactic nebulized antibiotics for ICU-acquired pneumonia management

Summaries 2 min 317

Font Size

Created On: 23/04/2025

Intensive care unit (ICU)-acquired pneumonia is a common complication among severely ill patients.

See All

Key take away

In critically ill patients, prophylactic nebulized antibiotics lower ICU-acquired pneumonia risk without affecting mortality, hospital stay, or ventilation duration.

Background

Intensive care unit (ICU)-acquired pneumonia is a common complication among severely ill patients. Hence, this systematic review and meta-analysis investigated prophylactic nebulized antibiotics for reducing the incidence of such pneumonia.

Method

An extensive search of Cochrane Library, PubMed, and Embase databases was carried out and six randomized controlled trials (RCTs) involving a total of 1,287 volunteers were included. In these trials, 636 volunteers were treated with prophylactic nebulized antibiotics (Polymyxin B, Tobramycin, Ceftazidime, Colistimethate sodium, and Amikacin), while 651 volunteers in the control group were treated with saline. The primary outcome ascertained was the emergence of ICU-acquired pneumonia. On the other hand, secondary outcomes were mortality, ICU hospitalization period, length of ventilatory support, and nebulization-associated adverse effects.

Result

Nebulized antibiotic prevention therapy markedly reduced the occurrence of ICU-acquired pneumonia when compared to the control group (odds ratio [OR] = 0.57). However, there was no vital difference in mortality between the two groups (OR = 0.86). The length of ICU stays (mean difference [MD] = 0.2 days) and mechanical ventilation days (MD = 0.43 days) were also not considerably affected. There was no indication that the antibiotic therapy led to multidrug-resistant bacterial pneumonia or heightened the risk of side effects like airway spasms.

Conclusion

Using prophylactic nebulized antibiotics successfully reduced ICU-acquired pneumonia in high-risk individuals without escalating the risk of respiratory infections caused by multidrug-resistant pathogens and airway spasms. However, this decrease did not arouse any significant changes in mortality or ICU stay duration.