Ventilator-associated Pneumonia
Conditions
Keywords
VAP, Critical care, Pharmacokinetics, Gentamicin
Brief summary
Ventilator associated pneumonia (VAP) remains in the intensive care unit the infection associated with the highest morbidity and mortality. Respiratory infection with resistant organism are increasing in prevalence. Because of lack of alternatives, amino glycoside, old antibiotics family, can be used for several infection. Aerosolized Amikacin or Tobramycin are used in mechanically ventilated patients for respiratory infections. Gentamicin,which is effective against numerous multi drug resistant Gram-negative organism and Gram-positive like Staphylococcus aureus, could be a great option for nebulisation. The investigators assume that nebulisation of gentamicin allows to obtain a higher lung concentration while assuring a systematic toxicity much lesser than a parenteral administration.
Interventions
DRUGgentamicin
Sponsors
Poitiers University Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* to be in critical care unit * to be mechanically ventilated * to have a ventilator-associated pneumonia requiring a treatment by gentamicin * to be affiliated to a national insurance scheme * to have given an informed consent (patient or close person)
Exclusion criteria
* to be obese (BMI \> 40 kg/m²) * to have been treated by gentamicin for 7 days * to be allergic to aminoglycoside * to have a severe respiratory failure (PaO2 / FiO2 \< 150) * to have a renal failure (Cl creat \< 60 ml/min/1.73m²) * to be under reinforced protection measure
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Peak Plasma Concentration (Cmax) | 3 days |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| PaO2/FiO2 ratio deterioration above 20%. | 3 days | Bronchodilators used. |
Countries
France
Outcome results
None listed