Methods to administer formulations of aminoglycoside and fosfomycin combination for treatment of ventilator associated pneumonia (VAP) and ventilator associated tracheal (VAT) bronchitis

摘要

The present invention is antibiotic compositions, ventilator-based systems and methods relating to ventilator-associated pneumonia (VAP) and ventilator-associated tracheal (VAT) bronchitis. Antibiotic combinations of fosfomycin and an aminoglycoside, preferably amikacin, are administered via an inline nebulizer within the airway of the ventilator. Humidified conditions create an improved aerosol mist to treat VAP and VAT.

主权项

1. A method to administer a combination of antibiotics during mechanical ventilation of a patient to prevent or alleviate ventilator associated pneumonia (VAP) or ventilator associated tracheal bronchitis (VAT) comprising:
establishing a positive pressure in the airway of a mechanical ventilator to provide assisted breathing to the patient, wherein the mechanical ventilator has means for introducing humidified air to the airway, connecting an inline nebulizer having an outlet into the airway, activating the nebulizer such that the nebulizer introduces an aerosol mist in the airway, wherein the mist is created from a solution stored in a reservoir therein and wherein the aerosol mist formed in the nebulizer is comprised of a distribution of particles having a mean particle size less than 5 microns; wherein the solution is a combination of a bactericidal combination of amikacin and fosfomycin at a ratio of amikacin to fosfomycin greater than 2.6:1 and in a hypertonic solution having at least 30 mEq/L permeant ion and an osmolality less than 1000 mOsmol/L; combining the aerosol mist with the humidified air such that the mean particle size of the aerosol mist increases by at least 10% and the osmolality decreases by at least 25%; and maintaining activation of the nebulizer until a dosage of amikacin and fosfomycin is delivered to achieve a MIC 90 for an organism selected from a Gram-positive organism and a Gram-negative organism and combinations thereof.