Inhaled Amikacin to Prevent Ventilator-Associated Pneumonia
Authors' conclusion
Among patients who had undergone mechanical ventilation for at least 3 days, a subsequent 3-day course of inhaled amikacin reduced the burden of ventilator-associated pneumonia during 28 days of follow-up.
Study context
- Population
- Critically ill adults on invasive mechanical ventilation for at least 72 hours847 analysed
- Participants
- 850 adults
- Comparison
- Amikacin vs Placebo
- Amikacinn = 417
- Placebon = 430reference
- Primary endpoint
- First episode of VAP
- Follow-up
- 28 days
Methodological detailsinvestigator-initiated, multicentre, double-blind, superiority, All three daily nebulizations received by 337 (81%) amikacin and 355 (83%) placebo patients
- Investigator-initiated
- Multicentre
- Double-blind
- Superiority
- All three daily nebulizations received by 337 (81%) amikacin and 355 (83%) placebo patients
Primary result
VAP
Difference in restricted mean survival time to VAP
1.5 days
95% CI 0.6–2.5
P = 0.004
Events by treatment group
Amikacin vs Placebo
difference in restricted mean survival time to VAP 1.5 days (95% CI 0.6–2.5); P = 0.004
As reported in the abstract
Further findings
| Outcome | Amikacin | Placebo | HR (95% CI) | |
|---|---|---|---|---|
| Infection-related ventilator-associated complication | 18% | 26% | 0.66 (0.50–0.89) | |
| 0.512Hazard ratio (log scale) |
Safety
Trial-related serious adverse effects
Original publication
Inhaled Amikacin to Prevent Ventilator-Associated Pneumonia. N Engl J Med. Published 25 October 2023. doi:10.
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