What is the role of aminoglycosides in the treatment of ventilator-associated pneumonia (VAP)?

Updated: Apr 15, 2021
  • Author: Kartika Shetty, MD, FACP; Chief Editor: John L Brusch, MD, FACP  more...
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Answer

Answer

In general, aminoglycosides should be avoided in the treatment of VAP. This also holds true for colistin. This recommendation is based on poor penetration of these agents in the lung tissue, in addition to the potential nephrotoxicity of aminoglycosides and the challenge in achieving therapeutic blood levels in patients with fluctuating renal function. Unfortunately, VAP due to Pseudomonas has a high failure rate, up to 40%, regardless of the antibiotic regimen. This rate is impacted by the resistance of the pathogen and initial antibiotic selection.


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