Global survey on nebulization of antimicrobial agents in mechanically ventilated XXXX : a call for international guidelines.

@entity1 @entity2890 @entity4509 @entity2489 @entity15388 @entity1729 @entity597
UNASSIGNED: Nebulized antimicrobial agents are increasingly administered for treatment of @entity1729 in mechanically ventilated (MV) @entity1 . A structured online questionnaire assessing the indications, dosages and recent patterns of use for nebulized antimicrobial agents in MV @entity1 was developed. The questionnaire was distributed worldwide and completed by 192 intensive care units. The most common indications for using nebulized antimicrobial agent were @entity2489 ( @entity2489 ; 58/87), @entity2489 ( @entity2489 ; 56/87) and management of multidrug-resistant, Gram-negative (67/87) bacilli in the respiratory tract. The most common prescribed nebulized agents were @entity15388 and @entity597 (36/87, 41.3% and 24/87, 27.5%), @entity2890 (32/87, 36.7%) and @entity4509 (23/87, 26.4%). @entity15388 , @entity4509 and @entity2890 daily doses for @entity2489 were significantly higher than for @entity2489 (p  <  0.05). Combination of parenteral and nebulized antibiotics occurred in 50 (86%) of 58 prescriptions for @entity2489 and 36 (64.2%) of 56 of prescriptions for @entity2489 . The use of nebulized antimicrobial agents in MV @entity1 is common. There is marked heterogeneity in clinical practice, with significantly different in use between @entity1 with @entity2489 and @entity2489 . Randomized controlled clinical trials and international guidance on indications, dosing and antibiotic combinations to improve clinical outcomes are urgently required.
