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Intensive Care Medicine

, Volume 35, Issue 10, pp 1792–1800 | Cite as

Nebulized ceftazidime in experimental pneumonia caused by partially resistant Pseudomonas aeruginosa

  • Fabio Ferrari
  • Qin Lu
  • Cassio Girardi
  • Olivier Petitjean
  • Charles-Hugo Marquette
  • Frederic Wallet
  • Jean-Jacques RoubyEmail author
  • the Experimental ICU Study Group
Experimental

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.

Keywords

Nebulization Ceftazidime Pneumonia Pseudomonas aeruginosa Mechanical ventilation Treatment 

Notes

Acknowledgments

The authors would like to thank to Arnold Dive and Michel Pottier for the preparation of the animals.

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Fabio Ferrari
    • 1
    • 2
  • Qin Lu
    • 1
    • 2
  • Cassio Girardi
    • 3
  • Olivier Petitjean
    • 4
  • Charles-Hugo Marquette
    • 5
  • Frederic Wallet
    • 6
  • Jean-Jacques Rouby
    • 1
    • 2
    Email author
  • the Experimental ICU Study Group
  1. 1.Réanimation Polyvalente Pierre Viars, Département d’Anesthésie-RéanimationUPMC Univ Paris 06, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de ParisParisFrance
  2. 2.Polyvalent Intensive Care Unit Pierre Viars, La Pitié-Salpêtrière HospitalUniversity Pierre et Marie CurieParisFrance
  3. 3.Department of AnesthesiologyFederal University of Sao PauloSão PauloBrazil
  4. 4.Department of PharmacologyAvicenne HospitalBobignyFrance
  5. 5.DHURE and INSERM U 416University of MedicineLilleFrance
  6. 6.Department of BacteriologyUniversity of MedicineLilleFrance

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