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Intensive Care Medicine
Published in: Intensive Care Medicine 10/2009

01-10-2009 | Experimental

Nebulized ceftazidime in experimental pneumonia caused by partially resistant Pseudomonas aeruginosa

Authors: Fabio Ferrari, Qin Lu, Cassio Girardi, Olivier Petitjean, Charles-Hugo Marquette, Frederic Wallet, Jean-Jacques Rouby, the Experimental ICU Study Group

Published in: Intensive Care Medicine | Issue 10/2009

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Abstract

Purpose

Ventilator-associated pneumonia caused by Pseudomonas aeruginosa with impaired sensitivity to ceftazidime is frequent in critically ill patients. The aim of the study was to compare lung tissue deposition and antibacterial efficiency between nebulized and intravenous administrations of ceftazidime in ventilated piglets with pneumonia caused by Pseudomonas aeruginosa with impaired sensitivity to ceftazidime.

Methods

Ceftazidime was administered 24 h following the intra-bronchial inoculation of Pseudomonas aeruginosa (minimum inhibitory concentration = 16 μg ml−1), either by nebulization (25 mg kg−1 every 3 h, n = 6) or by continuous intravenous infusion (90 mg kg−1 over 24 h after an initial rapid infusion of 30 mg kg−1, n = 6). Four non-treated inoculated animals served as controls. All piglets were killed 48 h (intravenous and control groups) or 51 h (aerosol group) after inoculation. Lung tissue concentrations and lung bacterial burden were assessed on multiple post-mortem sub-pleural lung specimens [(lower limit of quantitation = 102 colony forming unit (cfu g−1)].

Results

Ceftazidime trough lung tissue concentrations following nebulization were greater than steady-state lung tissue concentrations following continuous intravenous infusion [median and interquartile range, 24.8 (12.6–59.6) μg g−1 vs. 6.1 (4.6–10.8) μg g−1] (p < 0.001). After 24 h of ceftazidime administration, 83% of pulmonary segments had bacterial counts <102 cfu g−1 following nebulization and only 30% following intravenous administration (p < 0.001). In control animals, 10% of lung segments had bacterial counts <102 cfu g−1 48 h following bronchial inoculation.

Conclusion

Nebulized ceftazidime provides more efficient bacterial killing in ventilated piglets with pneumonia caused by Pseudomonas aeruginosa with impaired sensitivity to ceftazidime.
Appendix
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Metadata
Title
Nebulized ceftazidime in experimental pneumonia caused by partially resistant Pseudomonas aeruginosa
Authors
Fabio Ferrari
Qin Lu
Cassio Girardi
Olivier Petitjean
Charles-Hugo Marquette
Frederic Wallet
Jean-Jacques Rouby
the Experimental ICU Study Group
Publication date
01-10-2009
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 10/2009
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-009-1605-2

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