Effect Of Aerosolized Antibiotics On Patients With Ventilator Associated Pneumonia: A Meta-analysis

Objective: To evaluate the effect of aerosolized antibiotics on patients with ventilator associated pneumonia by meta-analysis.Methods: The data of this meta-analysis was retrieved from the PubMed,Cochrane library,Wanfang,Weipu and CNKI databases from January 1980 to June 2017.Randomized controlled trials(RCTs)regarding comparison of the effect of aerosolized antibiotics on patients with ventilator associated pneumonia were enrolled.The enrolled data were divided into different subgroups in terms of the kinds of aerosolized antibiotics.Meta-analysis was performed to compare the effect of different subgroups by RevMan 5.3.Results: 11 studies with a total of 827 patients were included.Aerosolized antibiotics improve the resolution(RR:1.17,95%CI:1.02~1.33,P=0.02),promoted weaning from mechanical ventilation(RR:1.49,95%CI:1.16~1.90,P=0.002),,compared with the control group,aerosolized antibiotics decrease the emergence of new drugresistant bacteria(RR:0.15,95%CI:0.04~0,49,P=0.002),more bronchospasm happenned(RR:2.40,95%CI:1.24~4.68,P=0.010),less nephrotoxicity happenned(RR : 0.57,95%CI : 0.40 ~ 1.82,P =0.003);while did not improve mortality.Subgroup analysis showed that compared with the control group,just aerosolized aminoglycoside antibiotics did not improve the bronchospasm happened.Conclusion: Aerosolized antibiotics improved resolution,weaning from mechanical ventilation,while did not improve mortality.Compared with the control group,aerosolized antibiotics decrease emergence of new drug-resistance and nephrotoxicity,improve bronchospasm happened.Compared with the control group,just aerosolized aminoglycoside antibiotics did not improve bronchospasm or decrease nephrotoxicity.