Exhaled nitric oxide (NO) is greater in asthma and reflects the degree of airway inflammation. The alveolar NO concentration (Calv) in interstitial pneumonia is reported to be increased.
As the researchers explain in the American Journal of Respiratory and Critical Care Medicine online April 7, the nebulization of antibiotics on experimental pneumonia inoculation produces high concentrations of lung tissue and rapid bacterial death.
For a Phase II clinical study of this strategy, Dr. Jean-Jacques Rouby, Hôpital Pitié-Salpêtrière in Paris, and colleagues randomly assigned 40 patients with VAP caused by susceptible strains or intermediate P. aeruginosa nebulized therapy or intravenously with ceftazidime and amikacin. An exception is made for three patients with intermediate P. aeruginosa in group IV, for whom the amikacin was replaced with ciprofloxacin.
However, they warn, "These benefits are obtained only if the spray conditions are adverse events and optimize such as filter clogging is detected early expiration. A multicenter randomized clinical trial large is needed to determine whether these potential benefits outweigh the risks of serious adverse events in patients with P. aeruginosa ventilator-associated pneumonia. "
