{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T10:42:48Z","timestamp":1771929768817,"version":"3.50.1"},"reference-count":99,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Respir Crit Care Med"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Global emergence of multidrug-resistant and extensive drug-resistant gram-negative bacteria has increased the risk of treatment failure, especially for healthcare- or ventilator-associated pneumonia (HAP\/VAP). Nebulization of antibiotics, by providing high intrapulmonary antibiotic concentrations, represents a promising approach to optimize the treatment of HAP\/VAP due to multidrug-resistant and extensive drug-resistant gram-negative bacteria, while limiting systemic antibiotic exposure. Aminoglycosides and colistin methanesulfonate are the most common nebulized antibiotics. Although optimal nebulized drug dosing regimen is not clearly established, high antibiotic doses should be administered using vibrating-mesh nebulizer with optimized ventilator settings to ensure safe and effective intrapulmonary concentrations. When used preventively, nebulized antibiotics reduced the incidence of VAP without any effect on mortality. This approach is not yet recommended and large randomized controlled trials should be conducted to confirm its benefit and explore the impact on antibiotic selection pressure. Compared with high-dose intravenous administration, high-dose nebulized colistin methanesulfonate seems to be more effective and safer in the treatment of ventilator-associated tracheobronchitis and VAP caused by multidrug resistant and extensive-drug resistant gram-negative bacteria. Adjunctive nebulized aminoglycosides could increase the clinical cure rate and bacteriological eradication in patients suffering from HAP\/VAP due to multidrug-resistant and extensive drug-resistant gram-negative bacteria. As nebulized aminoglycosides broadly diffuse in the systemic circulation of patients with extensive bronchopneumonia, monitoring of plasma trough concentrations is recommended during the period of nebulization. Large randomized controlled trials comparing high dose of nebulized colistin methanesulfonate to high dose of intravenous colistin methanesulfonate or to intravenous new \u03b2-lactams in HAP\/VAP due to multidrug-resistant and extensive drug-resistant gram-negative bacteria are urgently needed.<\/jats:p>","DOI":"10.1055\/s-0041-1740340","type":"journal-article","created":{"date-parts":[[2022,1,18]],"date-time":"2022-01-18T23:48:40Z","timestamp":1642549720000},"page":"255-270","source":"Crossref","is-referenced-by-count":8,"title":["Nebulized Antibiotics for Healthcare- and Ventilator-Associated Pneumonia"],"prefix":"10.1055","volume":"43","author":[{"given":"Matthieu","family":"Boisson","sequence":"additional","affiliation":[{"name":"INSERM U1070, Universit\u00e9 de Poitiers, UFR de M\u00e9decine Pharmacie, Poitiers, France"},{"name":"Service de Pr\u00e9vention et de Contr\u00f4le de l'Infection, H\u00f4pitaux Universitaires de Gen\u00e8ve, Gen\u00e8ve, Suisse"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrien","family":"Bougl\u00e9","sequence":"additional","affiliation":[{"name":"Medicine Sorbonne University, Anaesthesiology and Critical Care, Cardiology Institute, Paris, France"},{"name":"Department of Anaesthesiology and Critical Care, La Piti\u00e9-Salp\u00eatri\u00e8re Hospital, Assistance Publique H\u00f4pitaux de Paris, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Candela","family":"Sole-Lleonart","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Consorci Hospitalari de Vic (CHV), The University of Vic \u2013 Central University of Catalonia (UVic-UCC), Vic, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayesh","family":"Dhanani","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Centre for Clinical Research, The University of Queensland, The Royal Brisbane and Women's Hospital Herston, Brisbane, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kostoula","family":"Arvaniti","sequence":"additional","affiliation":[{"name":"Intensive Care Unit Department, Papageorgiou Hospital of Thessaloniki, Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordi","family":"Rello","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red (CIBERES), Instituto de Salud Carlos III, Madrid, Spain"},{"name":"Clinical Research and Innovation in Pneumonia and Sepsis, Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain"},{"name":"Clinical Research, CHU N\u00eemes, Universit\u00e9 Montpellier-N\u00eemes, N\u00eemes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Jacques","family":"Rouby","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Medicine Sorbonne University, Multidisciplinary Intensive Care Unit, La Piti\u00e9 Salp\u00eatri\u00e8re Hospital, Assistance Publique H\u00f4pitaux de Paris, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Mimoz","sequence":"additional","affiliation":[{"name":"INSERM U1070 Universit\u00e9 de Poitiers, UFR de M\u00e9decine Pharmacie and Service des Urgences Adultes & SAMU 86, Centre Hospitalier Universitaire de Poitiers, Poitiers, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"On Behalf of the European Investigator Network for Nebulized Antibiotics in Ventilator-Associated Pneumonia (ENAVAP)","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,1,18]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1001\/jama.2012.196377","article-title":"Effect of not monitoring residual gastric volume on risk of ventilator-associated pneumonia 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