{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T02:54:22Z","timestamp":1785207262256,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,2,12]],"date-time":"2023-02-12T00:00:00Z","timestamp":1676160000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003970","name":"Isfahan University of Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003970","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Although investigations are limited, adjunctive aerosolized antibiotics have been advised in the setting of gram\u2010negative ventilator\u2010associated pneumonia (VAP). This study aimed to compare the efficiency of inhaled colistin with inhaled fosfomycin\/tobramycin in treating VAP due to extensively drug\u2010resistant (XDR) <jats:styled-content style=\"fixed-case\"><jats:italic>Acinetobacter baumannii<\/jats:italic><\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This single center open\u2010label randomized controlled trial included 60 patients who developed XDR <jats:italic>A.\u00a0bumannii<\/jats:italic> VAP. Eligible participants were randomly assigned to two groups (no. 30). Regardless of the assignment, all participants received meropenem (2\u2009g as a 3\u2010h extended infusion every 8\u00a0h) plus intravenous colistin (a loading dose of 9 million IU and then 4.5 million IU every 12\u2009h). The control group was given inhaled colistin (1 million IU every 8\u00a0h), and the case group received inhaled tobramycin\/fosfomycin (300\u2009mg every 12\u2009h\/80\u2009mg every 12\u2009h) as adjunctive therapy. The primary outcome was treatment duration, and the secondary outcomes were Clinical Pulmonary Infection Score (CPIS) trend and mortality rate in the groups. The decision to stop treatment was made by the treating physician.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean treatment duration was 13.73\u2009\u00b1\u00a03.22\u2009days in the colistin group and 10.85\u2009\u00b1\u00a02.84\u2009days in the tobramycin\/fosfomycin group; the mean treatment duration in the latter group was lower significantly (<jats:italic>P<\/jats:italic>\u00a0=\u20090.001). CPIS was decreased in the groups significantly (<jats:italic>P<\/jats:italic>\u00a0&lt;\u20090.001), but the mean changes of CPIS were significantly different between the groups, and in the inhaled tobramycin\/fosfomycin group, a greater reduction (<jats:italic>P<\/jats:italic>\u00a0=\u20090.005) was observed. Two (6.67%) patients in the control group and three (10%) patients in the case group died.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The use of inhaled tobramycin\/fosfomycin in cases with XDR <jats:italic>A.\u00a0bumannii<\/jats:italic> VAP was associated with a shorter treatment duration in this open\u2010label trial.<\/jats:p><\/jats:sec>","DOI":"10.1111\/crj.13594","type":"journal-article","created":{"date-parts":[[2023,2,13]],"date-time":"2023-02-13T06:40:51Z","timestamp":1676270451000},"page":"295-302","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Comparing inhaled colistin with inhaled fosfomycin\/tobramycin as an adjunctive treatment for ventilator\u2010associated pneumonia: An open\u2010label randomized controlled trial"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9456-2239","authenticated-orcid":false,"given":"Atousa","family":"Hakamifard","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, School of Medicine Isfahan University of Medical Sciences  Isfahan Iran"},{"name":"Infectious Diseases and Tropical Medicine Research Center Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbas Ali","family":"Torfeh Esfahani","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, School of Medicine Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza","family":"Homayouni","sequence":"additional","affiliation":[{"name":"Research and Development Department Goldaru Pharmaceutical Company  Isfahan Iran"},{"name":"Department of Pharmaceutics, School of Pharmacy Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farzin","family":"Khorvash","sequence":"additional","affiliation":[{"name":"Nosocomial Infection Research Center Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Behrooz","family":"Ataei","sequence":"additional","affiliation":[{"name":"Nosocomial Infection Research Center Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saeed","family":"Abbasi","sequence":"additional","affiliation":[{"name":"Nosocomial Infection Research Center Isfahan University of Medical Sciences  Isfahan Iran"},{"name":"Anesthesiology and Critical Care Research Center Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro1789"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469\u20100691.2005.01227.x"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1753465810390262"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.9763"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200405-644ST"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0b013e328330abcf"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw353"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1009112"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102253\u201013\u201045"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010013\u20102872\u20105"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010015\u20100868\u2010y"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2006.051"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1086\/657242"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.05958\u201011"},{"key":"e_1_2_11_16_1","unstructured":"MontgomeryAB.Aminoglycoside and fosfomycin combination for treatment of ventilator associated pneumonia (VAP) and ventilator associated tracheal (VAT) bronchitis. Google Patents;2014."},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010019\u201053714\u20100"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40121\u2010020\u201000357\u20108"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201105\u20100924OC"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00051\u201005"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.54.10.867"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200212\u20101449OC"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469\u20100691.2011.03570.x"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.99.15.2011"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10156\u2010012\u20100430\u20107"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469\u20100691.2009.03040.x"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.13\u20101018"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/147.5.1279"},{"key":"e_1_2_11_29_1","unstructured":"LaiJ BrownJ StapletonKW inventors; Gilead Sciences Inc assignee.Dry powder fosfomycin\/tobramycin formulation for inhalation. 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