Inhaled antibiotics in intensive care medicine (survey of Russian intensivists). A retrospective observational study

Abstract

Introduction. The prevalence of nosocomial infections in Moscow hospitals is 7.61 %. In conditions of almost total poly- and pan-resistance of nosocomial pneumonia pathogens in intensive care units, the search for alternative methods of antibiotic therapy is urgent. One such alternative is inhaled antibiotics (IA). This publication presents the results of the study “nhalation antibiotics in resuscitation” based on a questionnaire survey of anesthesiologists-resuscitators. The purpose of this study is to analyze the frequency of use of inhaled forms of antibiotics for NP in intensive care patients in hospitals of the Russian Federation. Materials and methods. This survey was reviewed by two leading specialized specialists, approved on November 25, 2017 by the Committee for Recommendations and Organization of Research of the Federation of Anesthesiologists (http://www.far.org.ru/research/362-ingabx). The survey was conducted on 10.01.2018-30.10.2018. Results. According to the results of the study data were obtained on the prevalence of the use of IA for the treatment of nosocomial pneumonia (64 % of the respondents); indications (all respondents use Russian national guidelines; 80 % prescribe IA if the current antibiotic therapy regimen is ineffective); drugs used (colisthimetate sodium is used in 52 % of cases, tobramycin - 9 %, amikacin - 24 %, other (acetylcystein antibiotic, gentamicin, cephalosporins of various generations, bacteriophages) - 15 %) and equipment (more than 90 % use mesh-nebulizers), criteria for their cancellation (extremely scattered answers). Conclusion. The results of the questionnaire allow us to substantiate the advisability of additional randomized controlled trials on this issue.