Global survey on nebulization of antimicrobial agents in mechanically ventilated patients: a call for international guidelines.
Identifieur interne : 002F33 ( Ncbi/Merge ); précédent : 002F32; suivant : 002F34Global survey on nebulization of antimicrobial agents in mechanically ventilated patients: a call for international guidelines.
Auteurs : C. Solé-Lleonart [Espagne] ; J A Roberts [Australie] ; J. Chastre [France] ; G. Poulakou [Grèce] ; L B Palmer [États-Unis] ; S. Blot [Belgique] ; T. Felton [Royaume-Uni] ; M. Bassetti [Italie] ; C-E Luyt [France] ; J M Pereira [Portugal] ; J. Riera [Espagne] ; T. Welte [Allemagne] ; H. Qiu [République populaire de Chine] ; J-J Rouby [France] ; J. Rello [Espagne]Source :
- Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases [ 1469-0691 ] ; 2016.
Descripteurs français
- KwdFr :
- Anti-infectieux (administration et posologie), Aérosols (administration et posologie), Enquêtes et questionnaires, Humains, Infections de l'appareil respiratoire (traitement médicamenteux), Recommandations comme sujet, Résultat thérapeutique, Santé mondiale, Traitement médicamenteux (normes), Ventilation artificielle.
- MESH :
- administration et posologie : Anti-infectieux, Aérosols.
- normes : Traitement médicamenteux.
- traitement médicamenteux : Infections de l'appareil respiratoire.
- Enquêtes et questionnaires, Humains, Recommandations comme sujet, Résultat thérapeutique, Santé mondiale, Ventilation artificielle.
English descriptors
- KwdEn :
- MESH :
- chemical , administration & dosage : Aerosols, Anti-Infective Agents.
- drug therapy : Respiratory Tract Infections.
- standards : Drug Therapy.
- Global Health, Guidelines as Topic, Humans, Respiration, Artificial, Surveys and Questionnaires, Treatment Outcome.
Abstract
Nebulized antimicrobial agents are increasingly administered for treatment of respiratory infections in mechanically ventilated (MV) patients. A structured online questionnaire assessing the indications, dosages and recent patterns of use for nebulized antimicrobial agents in MV patients was developed. The questionnaire was distributed worldwide and completed by 192 intensive care units. The most common indications for using nebulized antimicrobial agent were ventilator-associated tracheobronchitis (VAT; 58/87), ventilator-associated pneumonia (VAP; 56/87) and management of multidrug-resistant, Gram-negative (67/87) bacilli in the respiratory tract. The most common prescribed nebulized agents were colistin methanesulfonate and sulfate (36/87, 41.3% and 24/87, 27.5%), tobramycin (32/87, 36.7%) and amikacin (23/87, 26.4%). Colistin methanesulfonate, amikacin and tobramycin daily doses for VAP were significantly higher than for VAT (p < 0.05). Combination of parenteral and nebulized antibiotics occurred in 50 (86%) of 58 prescriptions for VAP and 36 (64.2%) of 56 of prescriptions for VAT. The use of nebulized antimicrobial agents in MV patients is common. There is marked heterogeneity in clinical practice, with significantly different in use between patients with VAP and VAT. Randomized controlled clinical trials and international guidance on indications, dosing and antibiotic combinations to improve clinical outcomes are urgently required.
DOI: 10.1016/j.cmi.2015.12.016
PubMed: 26723563
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João EPE, University of Porto, Porto, Portugal.</nlm:affiliation><country xml:lang="fr">Portugal</country><wicri:regionArea>Emergency and Intensive Care Department, Centro Hospitalar S. João EPE, University of Porto, Porto</wicri:regionArea><wicri:noRegion>Porto</wicri:noRegion></affiliation></author><author><name sortKey="Riera, J" sort="Riera, J" uniqKey="Riera J" first="J" last="Riera">J. 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Solé-Lleonart</name><affiliation wicri:level="4"><nlm:affiliation>UHN and Mount Sinai Hospital, University of Toronto, Canada; Universitat Autonoma de Barcelona, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>UHN and Mount Sinai Hospital, University of Toronto, Canada; Universitat Autonoma de Barcelona, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region><settlement type="city">Toronto</settlement></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Roberts, J A" sort="Roberts, J A" uniqKey="Roberts J" first="J A" last="Roberts">J A Roberts</name><affiliation wicri:level="1"><nlm:affiliation>Burns Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Burns Trauma and Critical Care Research Centre, The University of Queensland, Brisbane</wicri:regionArea><wicri:noRegion>Brisbane</wicri:noRegion></affiliation></author><author><name sortKey="Chastre, J" sort="Chastre, J" uniqKey="Chastre J" first="J" last="Chastre">J. Chastre</name><affiliation wicri:level="3"><nlm:affiliation>Service de Réanimation Médicale, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie of Paris, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Réanimation Médicale, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie of Paris, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Poulakou, G" sort="Poulakou, G" uniqKey="Poulakou G" first="G" last="Poulakou">G. Poulakou</name><affiliation wicri:level="3"><nlm:affiliation>4th Department of Internal Medicine, Athens University School of Medicine, Attikon University General Hospital, Athens, Greece.</nlm:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>4th Department of Internal Medicine, Athens University School of Medicine, Attikon University General Hospital, Athens</wicri:regionArea><placeName><settlement type="city">Athènes</settlement><region nuts="2" type="region">Attique (région)</region></placeName></affiliation></author><author><name sortKey="Palmer, L B" sort="Palmer, L B" uniqKey="Palmer L" first="L B" last="Palmer">L B Palmer</name><affiliation wicri:level="2"><nlm:affiliation>Pulmonary, Critical Care, and Sleep Division, Department of Medicine, State University of New York at Stony Brook, Stony Brook, NY, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Pulmonary, Critical Care, and Sleep Division, Department of Medicine, State University of New York at Stony Brook, Stony Brook, NY</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Blot, S" sort="Blot, S" uniqKey="Blot S" first="S" last="Blot">S. Blot</name><affiliation wicri:level="4"><nlm:affiliation>Department of Internal Medicine, Faculty of Medicine and Health Science, Ghent University, Ghent, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Internal Medicine, Faculty of Medicine and Health Science, Ghent University, Ghent</wicri:regionArea><orgName type="university">Université de Gand</orgName><placeName><settlement type="city">Gand</settlement><region>Région flamande</region><region type="district" nuts="2">Province de Flandre-Orientale</region></placeName></affiliation></author><author><name sortKey="Felton, T" sort="Felton, T" uniqKey="Felton T" first="T" last="Felton">T. Felton</name><affiliation wicri:level="3"><nlm:affiliation>Acute Intensive Care Unit, University Hospital of South Manchester, Manchester, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Acute Intensive Care Unit, University Hospital of South Manchester, Manchester</wicri:regionArea><placeName><settlement type="city">Manchester</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="Bassetti, M" sort="Bassetti, M" uniqKey="Bassetti M" first="M" last="Bassetti">M. Bassetti</name><affiliation wicri:level="1"><nlm:affiliation>Infectious Diseases Division, Santa Maria Misericordia University Hospital, Udine, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Infectious Diseases Division, Santa Maria Misericordia University Hospital, Udine</wicri:regionArea><wicri:noRegion>Udine</wicri:noRegion></affiliation></author><author><name sortKey="Luyt, C E" sort="Luyt, C E" uniqKey="Luyt C" first="C-E" last="Luyt">C-E Luyt</name><affiliation wicri:level="3"><nlm:affiliation>Service de Réanimation Médicale, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie of Paris, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Réanimation Médicale, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie of Paris, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Pereira, J M" sort="Pereira, J M" uniqKey="Pereira J" first="J M" last="Pereira">J M Pereira</name><affiliation wicri:level="1"><nlm:affiliation>Emergency and Intensive Care Department, Centro Hospitalar S. João EPE, University of Porto, Porto, Portugal.</nlm:affiliation><country xml:lang="fr">Portugal</country><wicri:regionArea>Emergency and Intensive Care Department, Centro Hospitalar S. João EPE, University of Porto, Porto</wicri:regionArea><wicri:noRegion>Porto</wicri:noRegion></affiliation></author><author><name sortKey="Riera, J" sort="Riera, J" uniqKey="Riera J" first="J" last="Riera">J. Riera</name><affiliation wicri:level="3"><nlm:affiliation>Critical Care Department, Vall d'Hebron University Hospital, CIBERES, Vall d'Hebron Institute of Research, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Critical Care Department, Vall d'Hebron University Hospital, CIBERES, Vall d'Hebron Institute of Research, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Welte, T" sort="Welte, T" uniqKey="Welte T" first="T" last="Welte">T. Welte</name><affiliation wicri:level="3"><nlm:affiliation>Department of Pulmonary Medicine, Hannover Medical School, Hannover, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Pulmonary Medicine, Hannover Medical School, Hannover</wicri:regionArea><placeName><region type="land" nuts="2">Basse-Saxe</region><settlement type="city">Hanovre</settlement></placeName></affiliation></author><author><name sortKey="Qiu, H" sort="Qiu, H" uniqKey="Qiu H" first="H" last="Qiu">H. Qiu</name><affiliation wicri:level="1"><nlm:affiliation>Critical Care Department, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Critical Care Department, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing</wicri:regionArea><wicri:noRegion>Nanjing</wicri:noRegion></affiliation></author><author><name sortKey="Rouby, J J" sort="Rouby, J J" uniqKey="Rouby J" first="J-J" last="Rouby">J-J Rouby</name><affiliation wicri:level="3"><nlm:affiliation>Department of Anesthesiology and Critical Care, Multidisciplinary Intensive Care Unit, La Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, University Pierre et Marie Curie (UPMC) of Paris 6, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Anesthesiology and Critical Care, Multidisciplinary Intensive Care Unit, La Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, University Pierre et Marie Curie (UPMC) of Paris 6, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Rello, J" sort="Rello, J" uniqKey="Rello J" first="J" last="Rello">J. Rello</name><affiliation wicri:level="1"><nlm:affiliation>CIBERES, Universitat Autonoma de Barcelona, Spain. Electronic address: JRello@crips.es.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>CIBERES, Universitat Autonoma de Barcelona</wicri:regionArea><wicri:noRegion>Universitat Autonoma de Barcelona</wicri:noRegion></affiliation></author></analytic><series><title level="j">Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases</title><idno type="eISSN">1469-0691</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aerosols (administration & dosage)</term><term>Anti-Infective Agents (administration & dosage)</term><term>Drug Therapy (standards)</term><term>Global Health</term><term>Guidelines as Topic</term><term>Humans</term><term>Respiration, Artificial</term><term>Respiratory Tract Infections (drug therapy)</term><term>Surveys and Questionnaires</term><term>Treatment Outcome</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Anti-infectieux (administration et posologie)</term><term>Aérosols (administration et posologie)</term><term>Enquêtes et questionnaires</term><term>Humains</term><term>Infections de l'appareil respiratoire (traitement médicamenteux)</term><term>Recommandations comme sujet</term><term>Résultat thérapeutique</term><term>Santé mondiale</term><term>Traitement médicamenteux (normes)</term><term>Ventilation artificielle</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Aerosols</term><term>Anti-Infective Agents</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Anti-infectieux</term><term>Aérosols</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Respiratory Tract Infections</term></keywords><keywords scheme="MESH" qualifier="normes" xml:lang="fr"><term>Traitement médicamenteux</term></keywords><keywords scheme="MESH" qualifier="standards" xml:lang="en"><term>Drug Therapy</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Infections de l'appareil respiratoire</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Global Health</term><term>Guidelines as Topic</term><term>Humans</term><term>Respiration, Artificial</term><term>Surveys and Questionnaires</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Enquêtes et questionnaires</term><term>Humains</term><term>Recommandations comme sujet</term><term>Résultat thérapeutique</term><term>Santé mondiale</term><term>Ventilation artificielle</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Nebulized antimicrobial agents are increasingly administered for treatment of respiratory infections in mechanically ventilated (MV) patients. A structured online questionnaire assessing the indications, dosages and recent patterns of use for nebulized antimicrobial agents in MV patients was developed. The questionnaire was distributed worldwide and completed by 192 intensive care units. The most common indications for using nebulized antimicrobial agent were ventilator-associated tracheobronchitis (VAT; 58/87), ventilator-associated pneumonia (VAP; 56/87) and management of multidrug-resistant, Gram-negative (67/87) bacilli in the respiratory tract. The most common prescribed nebulized agents were colistin methanesulfonate and sulfate (36/87, 41.3% and 24/87, 27.5%), tobramycin (32/87, 36.7%) and amikacin (23/87, 26.4%). Colistin methanesulfonate, amikacin and tobramycin daily doses for VAP were significantly higher than for VAT (p < 0.05). Combination of parenteral and nebulized antibiotics occurred in 50 (86%) of 58 prescriptions for VAP and 36 (64.2%) of 56 of prescriptions for VAT. The use of nebulized antimicrobial agents in MV patients is common. There is marked heterogeneity in clinical practice, with significantly different in use between patients with VAP and VAT. Randomized controlled clinical trials and international guidance on indications, dosing and antibiotic combinations to improve clinical outcomes are urgently required.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">26723563</PMID><DateCreated><Year>2016</Year><Month>04</Month><Day>24</Day></DateCreated><DateCompleted><Year>2017</Year><Month>01</Month><Day>26</Day></DateCompleted><DateRevised><Year>2017</Year><Month>10</Month><Day>08</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1469-0691</ISSN><JournalIssue CitedMedium="Internet"><Volume>22</Volume><Issue>4</Issue><PubDate><Year>2016</Year><Month>Apr</Month></PubDate></JournalIssue><Title>Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases</Title><ISOAbbreviation>Clin. Microbiol. Infect.</ISOAbbreviation></Journal><ArticleTitle>Global survey on nebulization of antimicrobial agents in mechanically ventilated patients: a call for international guidelines.</ArticleTitle><Pagination><MedlinePgn>359-364</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S1198-743X(15)01042-3</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.cmi.2015.12.016</ELocationID><Abstract><AbstractText>Nebulized antimicrobial agents are increasingly administered for treatment of respiratory infections in mechanically ventilated (MV) patients. A structured online questionnaire assessing the indications, dosages and recent patterns of use for nebulized antimicrobial agents in MV patients was developed. The questionnaire was distributed worldwide and completed by 192 intensive care units. The most common indications for using nebulized antimicrobial agent were ventilator-associated tracheobronchitis (VAT; 58/87), ventilator-associated pneumonia (VAP; 56/87) and management of multidrug-resistant, Gram-negative (67/87) bacilli in the respiratory tract. The most common prescribed nebulized agents were colistin methanesulfonate and sulfate (36/87, 41.3% and 24/87, 27.5%), tobramycin (32/87, 36.7%) and amikacin (23/87, 26.4%). Colistin methanesulfonate, amikacin and tobramycin daily doses for VAP were significantly higher than for VAT (p < 0.05). Combination of parenteral and nebulized antibiotics occurred in 50 (86%) of 58 prescriptions for VAP and 36 (64.2%) of 56 of prescriptions for VAT. The use of nebulized antimicrobial agents in MV patients is common. There is marked heterogeneity in clinical practice, with significantly different in use between patients with VAP and VAT. Randomized controlled clinical trials and international guidance on indications, dosing and antibiotic combinations to improve clinical outcomes are urgently required.</AbstractText><CopyrightInformation>Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Solé-Lleonart</LastName><ForeName>C</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>UHN and Mount Sinai Hospital, University of Toronto, Canada; Universitat Autonoma de Barcelona, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Roberts</LastName><ForeName>J A</ForeName><Initials>JA</Initials><AffiliationInfo><Affiliation>Burns Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chastre</LastName><ForeName>J</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Service de Réanimation Médicale, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie of Paris, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Poulakou</LastName><ForeName>G</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>4th Department of Internal Medicine, Athens University School of Medicine, Attikon University General Hospital, Athens, Greece.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Palmer</LastName><ForeName>L B</ForeName><Initials>LB</Initials><AffiliationInfo><Affiliation>Pulmonary, Critical Care, and Sleep Division, Department of Medicine, State University of New York at Stony Brook, Stony Brook, NY, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Blot</LastName><ForeName>S</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Internal Medicine, Faculty of Medicine and Health Science, Ghent University, Ghent, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Felton</LastName><ForeName>T</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Acute Intensive Care Unit, University Hospital of South Manchester, Manchester, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bassetti</LastName><ForeName>M</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Infectious Diseases Division, Santa Maria Misericordia University Hospital, Udine, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Luyt</LastName><ForeName>C-E</ForeName><Initials>CE</Initials><AffiliationInfo><Affiliation>Service de Réanimation Médicale, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie of Paris, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pereira</LastName><ForeName>J M</ForeName><Initials>JM</Initials><AffiliationInfo><Affiliation>Emergency and Intensive Care Department, Centro Hospitalar S. João EPE, University of Porto, Porto, Portugal.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Riera</LastName><ForeName>J</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Critical Care Department, Vall d'Hebron University Hospital, CIBERES, Vall d'Hebron Institute of Research, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Welte</LastName><ForeName>T</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Pulmonary Medicine, Hannover Medical School, Hannover, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Qiu</LastName><ForeName>H</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Critical Care Department, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rouby</LastName><ForeName>J-J</ForeName><Initials>JJ</Initials><AffiliationInfo><Affiliation>Department of Anesthesiology and Critical Care, Multidisciplinary Intensive Care Unit, La Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, University Pierre et Marie Curie (UPMC) of Paris 6, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rello</LastName><ForeName>J</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>CIBERES, Universitat Autonoma de Barcelona, Spain. Electronic address: JRello@crips.es.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>ESGCIP Investigators</CollectiveName></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>G1000417</GrantID><Agency>Medical Research Council</Agency><Country>United Kingdom</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2015</Year><Month>12</Month><Day>23</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Clin Microbiol Infect</MedlineTA><NlmUniqueID>9516420</NlmUniqueID><ISSNLinking>1198-743X</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000336">Aerosols</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000890">Anti-Infective Agents</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000336" MajorTopicYN="N">Aerosols</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000890" MajorTopicYN="N">Anti-Infective Agents</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004358" MajorTopicYN="N">Drug Therapy</DescriptorName><QualifierName UI="Q000592" MajorTopicYN="N">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014943" MajorTopicYN="N">Global Health</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017408" MajorTopicYN="N">Guidelines as Topic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012121" MajorTopicYN="Y">Respiration, Artificial</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012141" MajorTopicYN="N">Respiratory Tract Infections</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011795" MajorTopicYN="N">Surveys and Questionnaires</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Colistin</Keyword><Keyword MajorTopicYN="N">dosage</Keyword><Keyword MajorTopicYN="N">mechanical ventilated</Keyword><Keyword MajorTopicYN="N">nebulized antibiotics</Keyword><Keyword MajorTopicYN="N">pulmonary infections</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2015</Year><Month>09</Month><Day>15</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2015</Year><Month>11</Month><Day>26</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2015</Year><Month>12</Month><Day>12</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2016</Year><Month>1</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2016</Year><Month>1</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>1</Month><Day>27</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">26723563</ArticleId><ArticleId IdType="pii">S1198-743X(15)01042-3</ArticleId><ArticleId IdType="doi">10.1016/j.cmi.2015.12.016</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Belgique</li><li>Espagne</li><li>France</li><li>Grèce</li><li>Italie</li><li>Portugal</li><li>Royaume-Uni</li><li>République populaire de Chine</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Attique (région)</li><li>Basse-Saxe</li><li>Catalogne</li><li>Grand Manchester</li><li>Province de Flandre-Orientale</li><li>Région flamande</li><li>État de New York</li><li>Île-de-France</li></region><settlement><li>Athènes</li><li>Barcelone</li><li>Gand</li><li>Hanovre</li><li>Manchester</li><li>Paris</li><li>Toronto</li></settlement><orgName><li>Université de Gand</li><li>Université de Toronto</li></orgName></list><tree><country name="Espagne"><region name="Catalogne"><name sortKey="Sole Lleonart, C" sort="Sole Lleonart, C" uniqKey="Sole Lleonart C" first="C" last="Solé-Lleonart">C. 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