292. Clinical Experience with Aerosolized Antimicrobial Therapy in an Academic Tertiary Care Hospital
Session: Poster Abstract Session: Antimicrobial Therapy: Clinical Studies
Friday, October 21, 2011
Room: Poster Hall B1
Background:

Aerosolized antimicrobial therapy has been utilized for the management of respiratory tract infections given the high penetration at the site of infection and limited risk for systemic adverse effects. Despite the availability of treatment guidelines, the role and effectiveness of aerosolized antimicrobial agents for the treatment of pulmonary infections remain uncertain.

Methods:

Patients who received at least one dose of aerosolized antimicrobial therapy between October 1, 2009 and October 31, 2010 were identified for inclusion in the retrospective study. Several patient-, treatment-, and outcome-related data parameters were collected. Descriptive and univariate analyses were conducted; multivariate analysis was not performed.

Results: 

A total of 23 patients with 31 courses of aerosolized antimicrobial therapy were evaluated. The majority of patients were adults (median age 50 years) with ventilator-associated pneumonia (VAP) or hospital-acquired pneumonia (HAP) in the Surgical Intensive Care Unit (14/23, 61%). The most commonly prescribed aerosolized anti-infective was tobramycin (11/31 courses, 35%), and dosage regimens for most agents were inconsistent. Multi-drug resistant Pseudomonas aeruginosa and Klebsiella pneumoniae were the predominant pathogens identified. Seventeen patients experienced clinical cure or improvement, while only 6 patients had documented microbiological eradication. Patients with HAP or VAP were more likely to achieve clinical cure or improvement (90% vs. 55%, p = 0.037), but those with Pseudomonas infections were less likely to eradicate their cultures (0% vs. 33%, p = 0.025). Admission to an Intensive Care Unit, use of agents other than tobramycin, and diagnosis of HAP or VAP were predictors for prolonged hospitalization. No adverse events related to aerosolized antimicrobial therapy were noted.

Conclusion:  

Aerosolized antimicrobial therapy was predominantly prescribed for the treatment of HAP or VAP with multi-drug resistant gram-negative pathogens in an academic tertiary care hospital. Positive treatment outcomes were noted in most patients, and aerosolized therapy was well-tolerated.


Subject Category: J. Clinical practice issues

Shin-Pung Jen, PharmD1, Shobha Swaminathan, MD2, Rajendra Kapila, MD2 and Helen Horng, PharmD1, (1)The University Hospital, Newark, NJ, (2)UMDNJ - New Jersey Medical School, Newark, NJ

Disclosures:

S. P. Jen, None

S. Swaminathan, None

R. Kapila, None

H. Horng, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.