Not only the detection but also the treatment of airway pathogens has become a major problem in intensive care units. As mentioned by the WHO multi drug-resistant organisms are a problem and will have a great impact on our clinical work in the future. In all the discussions on restricting antibiotic usage and infection control comes this article by Palmer et al. where they look at actually reducing antibiotic resistance by using antibiotics - Inhaled antibiotics. In itself actually a breach of paradigm.
In a double-blind placebo-controlled study including a rather small group of critically ill intubated patients they found that aerosolised antibiotics successfully eradicated existing multi-drug resistant organisms and therefore reduced the pressure from systemic agents for new resistance.
While this article is not open access, the editorial by M. Bonten is.
Palmer LB et al. Am J of Resp and Crit Care Med, Vol. 189, No. 10 (2014), pp. 1225-1233
MJM Bonten, Editorial, Am J of Resp and Crit Care Med, 2014
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