Can Inhaled Amikacin Lower Risk for Ventilator-Associated Pneumonia?

For several years, guidelines have supported use of a bundle of interventions (e.g., targeted sedation, elevation of the head of the bed) to prevent ventilator-associated pneumonia (VAP). Despite these strategies, patients in intensive care units (ICUs) often develop VAP, which can result in longer length of stay, more antimicrobial use, and death. The search for more-effective preventive practices continues.

Investigators from France enrolled nearly 850 patients from 19 ICUs who were supported with mechanical ventilation for 72 to 96 hours. Patients were randomized to either 3 days of daily inhaled amikacin or placebo. VAP was diagnosed based on guideline definitions (Clin Infect Dis 2016; 63:e61) and adjudicated by a blinded outside commit…