Table 1 Characteristics of comparative trials included in the meta-analysis
Reference | Year | Type of trial | Study quality score | Study population/setting | Method for the micro-biological diagnosis of pneumonia | Length of ICU stay (days) | Duration of mechanical ventilation (days) | Studied drug/dosage | Drug administration | Mode of administration | ITT | No. of patients clinically evaluable |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Wood et al. [21] | 2002 | Double-blind, placebo-controlled RCT | 5 | Mechanically ventilated for >2 days, trauma patients with >1 risk factor for post-traumatic pneumonia; ICU; USA | Bronchoalveolar lavage | 19 ± 11 vs 21 ± 12 | 16 ± 11 vs 18 ± 13 | Ceftazidime: 250 mg every 12 hours | For 7 days | Aerosolized | 59 | 20 vs 20 |
Rouby et al. [19] | 1994 | Non-randomized clinical trial | NA | Mechanically ventilated for >3 days; surgical ICU; France | Bronchoalveolar lavage | No data | Survivors: 18 ± 12 vs 12 ± 14 Non-survivors: 9 ± 5 vs 8 ± 4 | Colistin: 200,000 units every 3 h | For 2 weeks | Endotracheal instillation | 598 | 347 vs 251 |
Rathgeber et al. [18] | 1993 | RCT | 2 | Mechanically ventilated; ICU; Germany | Bronchial secretions | No data | 17 vs 13 | Tobramycin: 80 mg every 6 hours | Until the time of extubation | Aerosolized | 69 | 29 vs 40 |
Lode et al. [17] | 1992 | Double-blind, placebo-controlled, RCT | 2 | Mechanically ventilated for >3 days; 5 European ICUs | No data | No data | No data | Gentamicin: 40 mg every 6 hours | Until the time of extubation (<14 days) | Endotracheal instillation | 199 | 85 vs 77 |
Vogel et al. [20] | 1981 | Non-randomized, controlled clinical trial | NA | Mechanically ventilated for >5 days; medical ICU; Germany | Tracheal aspirates | No data | 8.3 vs 7.4 | Gentamicin: 40 mg every 6 hours | For 2 weeks | Endotracheal instillation | 40 | 20 vs 20 |
Klick et al. [15] | 1975 | Double-blind, placebo-controlled, non-randomized clinical trial | NA | Mechanically ventilated or not; respiratory-surgical ICU; USA | Sputum; Tracheal aspirates | 5.1 vs 5.3 | No data | Polymyxin B: 2.5 mg/kg body weight/day in 6 divided doses | Throughout the entire ICU stay | Aerosolized | 744 | 355 vs 337 |
Klatersky et al. [13] | 1974 | Placebo-controlled RCT | 3 | Tracheostomised neurosurgical ICU; Belgium | Sputum; tracheal aspirates; bronchial secretions | 19.9 vs 14.7 | NA | Gentamicin: 80 mg every 8 hours | Throughout the entire ICU stay | Endotracheal instillation | 110 | 43 vs 42 |
Greenfield et al. [11] | 1973 | RCT | 1 | Mechanically ventilated or not, high-risk patients; respiratory-surgical ICU; USA | Sputum | 9.0 (median 6.0) vs 7.6 (median 6.0) | No data | Polymyxin B: 2.5 mg/kg body weight/day in 6 divided doses | Throughout the entire ICU stay | Aerosolized | 58 | 33 vs 25 |