Abstract

Background: Ventilator associated pneumonia is an intractable problem in critically ill intubated patients in the ICU where the respiratory infections persist despite treatment with potent systemic antibiotics. Objective: The purpose of this study is to determine the effect of antibiotics administered as a prophylactic via the respiratory tract which achieve a high drug concentration in the target organ in the prevention of ventilator associated pneumonia (VAP). Methods: 40 patients were studied in two groups, each group of 20 patients, in the intensive care unit of GHAZI-AL HARIRI general hospital in BAGHDAD MEDICAL CITY from (May 2019 to November 2019). Critically ill intubated patients were randomized above 18 years of age, from both gender, intubated at least for 3 days and expected to survive for more than one week. The 1st group (A) treated with amikacin via the respiratory tract by the nebulizer in addition to the systemic antibiotics, the 2nd group (B) treated with systemic antibiotics only. Results: From the 40 patients who were studied, 2 patients from group (A) who received amikacin nebulizer in addition to the systemic antibiotics were developed ventilator associated pneumonia while 18 patients not developed signs and symptoms or radiological features suggesting a diagnosis of pneumonia. From the other group (B) who received just the systemic antibiotics 9 patients were developed ventilator associated pneumonia and the other 11 patients didn’t develop VAP. Conclusion: Our study showed that the use of amikacin via the respiratory tract by a nebulizer can have a role in the prevention of ventilator associated pneumonia in critically ill intubated patients