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Point and Counterpoint |

Point: Should inhaled antibiotic therapy be routinely used for the treatment of bacterial lower respiratory tract infections in the ICU setting? Yes

Richard G. Wunderink, MD, FCCP
Author and Funding Information

Conflict of interest statement: Dr. Wunderink has personally received consultation fees from Bayer

Professor of Medicine, Northwestern University Feinberg School of Medicine, 676North St. Clair Street, Arkes 14-015, Chicago, IL USA, 60611

Correspondence to: Richard G. Wunderink.


Copyright 2016, . All Rights Reserved.


Chest. 2016. doi:10.1016/j.chest.2016.11.006
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Abstract

Routine use of aerosolized antibiotics is the most rational approach to the current treatment dilemmas for severe hospital-acquired pneumonia (HAP) requiring endotracheal intubation or ventilator-associated pneumonia (VAP). The two main issues for HAP/VAP are inappropriate initial therapy and ineffective therapy for multidrug resistant (MDR) pathogens, particularly gram negative bacilli such as Pseudomonas aeruginosa and Acinetobacter species. The emergence of extended spectrum beta-lactamases (ESBL) and carbapenem resistance in Enterobacteriaceae (CRE) have made even common pathogens such as Escherichia coli difficult to treat.


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    Print ISSN: 0012-3692
    Online ISSN: 1931-3543