Prevention of gram-negative bacillary pneumonia using polymyxin aerosol as prophylaxis. II. Effect on the incidence of pneumonia in seriously ill patients

All 744 patients admitted to a Respiratory-Surgical Intensive Care Unit (RSICU) were included in a prospective study of the effects of a polymyxin (2.5 mg/kg body wt/day in six divided doses) or a placebo aerosol sprayed into the posterior pharynx and tracheal tube (if present), during 11 alternatin...

Full description

Saved in:
Bibliographic Details
Published in:The Journal of clinical investigation 1975-03, Vol.55 (3), p.514-519
Main Authors: Klick, J M, du Moulin, G C, Hedley-Whyte, J, Teres, D, Bushnell, L S, Feingold, D S
Format: Article
Language:English
Subjects:
Aerosols
Anti-Bacterial Agents - therapeutic use
Bacteria - growth & development
Bacteria - isolation & purification
Boston
Cross Infection - microbiology
Cross Infection - prevention & control
Humans
Middle Aged
Placebos
Pneumonia - epidemiology
Pneumonia - microbiology
Pneumonia - prevention & control
Polymyxins - administration & dosage
Polymyxins - therapeutic use
Pseudomonas aeruginosa - growth & development
Pseudomonas aeruginosa - isolation & purification
Pseudomonas Infections - epidemiology
Pseudomonas Infections - prevention & control
Respiratory Insufficiency - drug therapy
Respiratory System - microbiology
Sodium Chloride - administration & dosage
Sodium Chloride - therapeutic use
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:All 744 patients admitted to a Respiratory-Surgical Intensive Care Unit (RSICU) were included in a prospective study of the effects of a polymyxin (2.5 mg/kg body wt/day in six divided doses) or a placebo aerosol sprayed into the posterior pharynx and tracheal tube (if present), during 11 alternating 2-mo treatment cycles. The incidence of upper airway colonization in the RSICU with Pseudomonas aeruginosa was 1.6% during the polymyxin treatment cycles (total 374 patients) and 9.7% during the placebo cycles (370 patients) (X2 equals 23.2, P less than 0.01). 3 patients in the RSICU acquired Pseudomonas pneumonia, as defined by independent "blinded" assessors, during the polymyxin cycles while 17 acquired a Pseudomonas pneumonia during the placebo cycles (X2 equals 10.2, P less than 0.01). The overall mortality was similar in both placebo and polymyxin-treated groups (12.2 vs. 12.0%). Systemic antibiotic usage was similar in the different cycles; 49% of patients in the placebo and 53% in the polymyxin-treated groups received systemic antibiotics while in the RSICU.
ISSN:0021-9738
DOI:10.1172/JCI107957