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Nebulized aminoglycosides for ventilator-associated pneumonia: Methodological considerations and lessons from experimental studies.
J Intensive Med
January 2025
Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona - SGR 911- Ciber de Enfermedades Respiratorias (Ciberes), Barcelona, Spain.
Aminoglycosides are concentration-dependent antibiotics exerting a bactericidal effect when concentrations at the site of infection are equal to or greater than 5 times the minimum inhibitory concentrations (MIC). When administered intravenously, they exhibit poor lung penetration and high systemic renal and ototoxicity, imposing to restrict their administration to 5 days. Experimental studies conducted in anesthetized and mechanically ventilated sheep and pigs provide evidence that high doses of nebulized aminoglycosides induce a rapid and potent bacterial killing in the infected lung parenchyma.
View Article and Find Full Text PDFIn vitro Antibacterial Effect of Reduning Combined with Polymyxin on Carbapenem Resistant .
Infect Drug Resist
January 2025
Department of Clinical Laboratory, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, 310012, People's Republic of China.
Objective: This study aimed to investigate the status of carbapenem-resistant strains of isolated from the Department of Microbiology, Zhejiang Tongde Hospital between September 2023 and February 2024, and to examine the in vitro antibacterial effect of Reduning combined with polymyxin on carbapenem-resistant (CRKP), which may provide evidence on the application of Reduning in the clinical anti-infective therapy.
Methods: A total of 50 different isolates of CRKP were collected, and the minimum inhibitory concentrations (MIC) of polymyxin, Reduning and polymyxin plus Reduning were measured with microbroth dilution method. Then, the fractional inhibition concentration index (FICI) was calculated.
In vivo systemic vancomycin determination from polymethyl methacrylate and morselized bone allograft used in two stage septic knee revision arthroplasty.
Germs
September 2024
MD, PhD, Professor, Department of Orthopedics, Carol Davila University of Medicine and Pharmacy, No. 8 Eroii Sanitari Boulevard, Bucharest, 050474, Romania.
Introduction: This paper examines the use of local antibiotic therapy in one-stage septic revision surgery for late periprosthetic joint infections (PJIs). This case study suggests that morselized bone allografts impregnated with antibiotics in powder form are a preferable alternative to polymethyl methacrylate (PMMA) because they can generate higher local antibiotic concentrations. Current research also recommends using vancomycin and aminoglycosides as the preferred choice of antibiotics, as they may have low diffusion in tissues when administered intravenously, but are effective when administered locally.
View Article and Find Full Text PDFEmergence and clinical challenges of ST11-K64 carbapenem-resistant Klebsiella pneumoniae: molecular insights and implications for antimicrobial resistance and virulence in Southwest China.
BMC Infect Dis
January 2025
Department of Clinical Laboratory, Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, the First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Background: In clinical practice, the emergence of ST11-K64 carbapenem-resistant Klebsiella pneumoniae (ST11-K64 CRKP) has become increasingly alarming. Despite this trend, limited research has been conducted to elucidate the clinical and molecular characteristics of these strains.
Objectives: This study aimed to comprehensively investigate the clinical characteristics, antimicrobial resistance patterns, resistance and virulence-associated genes, and molecular epidemiology of ST11-K64 CRKP in Southwest China.
Jet versus vibrating mesh nebulizer for tobramycin aerosol in spontaneously breathing children with tracheostomies: A simulation study.
Anaesth Crit Care Pain Med
December 2024
Perioperative Care Program, Perioperative Medicine Team, Telethon Kids Institute, Northern Entrance, Perth Children's Hospital, 15 Hospital Ave, Nedlands WA 6009, Perth, Australia; Division of Emergency Medicine, Anaesthesia and Pain Medicine, Medical School, The University of Western Australia, 35 Stirling Hwy, Crawley WA 6009, Perth, Australia; Institute for Paediatric Perioperative Excellence, The University of Western Australia, 35 Stirling Hwy, Crawley WA 6009, Perth, Australia; Department of Anaesthesia and Pain Medicine, Perth Children's Hospital, 15 Hospital Ave, Nedlands WA 6009, Perth, Australia. Electronic address:
Article Synopsis
- Tracheostomy tubes increase the risk of respiratory infections, and initial treatment often involves nebulized tobramycin, but there’s a lack of standardized treatment guidelines.
- A study used a breathing simulator to test how much tobramycin reaches simulated children with tracheostomies, comparing delivery methods and doses for different child weights.
- Results showed that jet nebulizers delivered significantly more tobramycin than vibrating mesh nebulizers, highlighting the need for better dosing strategies and further research on drug delivery efficiency and higher dosages for this patient group.
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