clinical-pharmacy-2017-posters-accepted-abstracts

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Journal of Pharmacology and Therapeutic Research
Volume 1 Issue 1 Clinical Pharmacy 2017
Notes:
Page 57
December 07-09, 2017 | Rome, Italy
7th World Congress on
Clinical Pharmacy and Pharmacy Practice
Inhaled Amikacin in hospital acquired
pneumonia post cardiac surgeries
Nirmeen A Sabry1, Nehal A Hassan2, Faten Farid Awdallah2 and
Maggie M Abbassi1
1Cairo University, Egypt
2National Heart Institute, Egypt
Objective: Nebulized antibiotics offer high efficacy due
to significant local concentrations and safety with minimal
blood levels. This study evaluates the efficacy and
nephrotoxicity of nebulized versus intravenous amikacin
in post cardiothoracic surgical patients with nosocomial
pneumonia caused by multi-drug resistant gram-negative
bacilli.
Design & Patients: Prospective, randomized, controlled
study on surgical patients divided into two groups. The
first group was administered intravenous amikacin 20
mg/kg once daily. The second group was prescribed
amikacin nebulizer 400 mg twice daily. Both groups were
co-administered intravenous piperacillin/tazobactam
empirically. Recruited patients were diagnosed by either
hospital acquired pneumonia or ventilator associated
pneumonia where 56 (42.1%) patients were diagnosed
with hospital acquired pneumonia, 51 (38.34%) patients
were diagnosed with early ventilator associated
pneumonia and 26 (19.54%) patients with late ventilator
associated pneumonia.
Measurements & Main Results: Clinical cure in both
groups was assessed on day 7 of treatment was the
primary outcome. Efficacy was additionally evaluated
through assessing the length of hospital stay, ICU
stay, days on amikacin, days on mechanical ventilator,
mechanical ventilator free days, days to reach clinical cure,
and mortality rate. Lower nephrotoxicity in the nebulized
group was observed through significant preservation of
kidney function (p<0.001). Although both groups were
comparable regarding length of hospital stay, nebulizer
group showed shorter ICU stay (p=0.010), lower number
of days to reach complete clinical cure (p=0.001), fewer
days on mechanical ventilator (p=0.035), and fewer days
on amikacin treatment (p=0.022).
Conclusion: Nebulized amikacin is a less nephrotoxic
option which was associated with less deterioration in
kidney function besides lower trough levels and more
effective option which was associated with better clinical
cure rates, less ICU stay, and fewer days to reach
complete recovery compared to IV amikacin for surgical
patients with nosocomial pneumonia.
J Pharmacol Ther Res 2017