Table 1 Study characteristics and quality assessment
From: Nebulized antibiotics for ventilator-associated pneumonia: a systematic review and meta-analysis
Study, year | Country | Number of patients (inhaled ± intravenous antibiotic/intravenous only) | Isolated bacteria (n) | Nebulizer device | Inhaled antibiotic given (daily dose) | Quality assessment |
|---|---|---|---|---|---|---|
Observational studies | Â | Â | Â | Â | Â | Newcastle-Ottawa Scale |
 Doshi, 2013 [21] | USA | 44/51 | Acinetobacter (61), Pseudomonas (53), ESBL Enterobacteria (11) | Jet or vibrating mesh nebulizer | Colistin 150-300 mg | 7 |
 Ghannam, 2009 [22] | USA | 16/16 | Pseudomonas (22), Klebsiella (5), Stenotrophomonas (3), Serratia (2), E. coli (1), Acinetobacter (1) | Jet nebulizer | Gentamicin 300-400 mg, Amikacin 200-300 mg, Tobramycin 600-900 mg or Colistin 300 mg | 9 |
 Kalin, 2012 [23] | Turkey | 29/15 | Acinetobacter (10) | Device not described. Nebulization with oxygen flow of 8 l/min | Colistin 300 mg | 9 |
 Kofteridis, 2010 [24] | Greece | 43/43 | Acinetobacter (66), Klebsiella (12), Pseudomonas (8) | Not described | Colistin 150 mg | 9 |
 Korbila, 2010 [29] | Greece | 78/43 | Acinetobacter (92), Pseudomonas (17), Klebsiella (4) | Ultrasonic nebulizer | Colistin 150 mg | 9 |
 Tumbarello, 2013 [31] | Italy | 104/104 | Acinetobacter (128), Pseudomonas (52), Klebsiella (28) | Jet or ultrasonic nebulizer | Colistin 225 mg | 9 |
Randomized controlled trials | Â | Â | Â | Â | Â | Cochrane risk of bias |
 Hallal, 2007 [25] | USA | 5/5 | Pseudomonas (9), Acinetobacter (3), Staphylococcus (3) | Jet nebulizer | Tobramycin 600 mg | High |
 Le Conte, 2000 [26] | France | 21/17 | Pseudomonas (16), Haemophilus (6), Enterobacter (4), E. coli (3), Klebsiella (1) | Balloon with a valve connected to the endotracheal tube | Tobramycin 2.5 mg/kg | High |
 Lu, 2011 [27] | France | 20/20 | Pseudomonas (40) | Vibrating nebulizer | Ceftazidime 120 mg/kg or Amikacin 25 mg/kg | High |
 Niederman, 2012 [28] | France/Spain/USA | 47a/22 | Pseudomonas (24), E. coli (14), Klebsiella (10), Acinetobacter (7) | Vibrating mesh nebulizer | Amikacin 800 mg | Low |
 Palmer, 2014 [30] | USA | 24/18 | Staphylococcus (18), Acinetobacter (12), Pseudomonas (9), Klebsiella (5), Enterobacter (4), Other (9)b | Jet nebulizer | Vancomycin 360 mg and/or Gentamicin 240 mg or Amikacin 1200 mg | High |
 Rattanaumpawan, 2010 [32] | Thailand | 51/49 | Acinetobacter (65), Pseudomonas (34), Klebsiella (20), E. coli (7), Enterobacter (3), Stenotrophomonas (2) | Jet or ultrasonic nebulizer | Colistin 150 mg | High |