Nebulized antibiotics seem to be associated with higher rates of clinical cure in the treatment of ventilator-associated pneumonia (VAP). However, the apparent benefit in the clinical cure rate observed by traditional meta-analysis does not persist after trial sequential analysis, according to a study published in Critical Care.

In an analysis of 12 studies and 812 patients, nebulized antibiotics were associated with higher rates of clinical cure (risk ratio (RR)?=?1.23; 95% confidence interval (CI), 1.05-1.43; I2?=?34%; D2?=?45%).

However, nebulized antibiotics were not associated with microbiological cure, mortality, duration of mechanical ventilation, ICU length of stay or renal toxicity.