SynthesisBMJ open2025
Effect of nebulised inhalation of antibiotics on preventing ventilator-associated pneumonia in critically ill patients: a systematic review and meta-analysis.
Synthesis in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed.
- Review
- Practices and Perceptions of Infectious Diseases and Critical Care Clinicians Regarding Aerosolized Antimicrobial Therapy in the State of Qatar: A Multicenter Cross-Sectional Study.Antibiotics (Basel, Switzerland) · 2026Article
- Ventilator-Associated Pneumonia (VAP) in Neurocritical Patients: The Hidden Dialog of Brain and Infection.Biomedicines · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate whether prophylactic nebulised antibiotic inhalation reduces the incidence of ventilator-associated pneumonia (VAP) in critically ill adults undergoing mechanical ventilation. STUDY
designSystematic review and meta-analysis of randomised controlled trials. DATA SOURCES: PubMed, Embase and the Cochrane Central Register of Controlled Trials were searched from inception to 1 January 2024 without language restrictions. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We included randomised controlled trials comparing prophylactic nebulised antibiotics with placebo or no treatment in mechanically ventilated adult intensive care unit (ICU) patients. Two independent reviewers conducted data extraction and assessed risk of bias. A meta-analysis was performed using random-effects models to calculate relative risks (RRs) for VAP and secondary outcomes.
resultsOf the 2663 studies screened, four were deemed suitable for analysis, involving a total of 1160 patients (574 receiving prophylactic antibiotics via nebulised inhalation). Nebulised antibiotics reduced the incidence of VAP compared with control (RR 0.70, 95% CI 0.52 to 0.93, I²=38%, low-certainty). There were no statistically significant differences in ICU mortality (RR 0.89, 95% CI 0.73 to 1.09, I²=0%, low-certainty, moderate-certainty) or hospital mortality (RR 0.93, 95% CI 0.78 to 1.11, I²=0%, moderate-certainty). Risk of bias varied across studies, with one trial assessed as high risk, one with some concerns and two with low risk.
conclusionsNebulised prophylactic antibiotics may reduce the incidence of VAP in critically ill patients receiving mechanical ventilation, though secondary outcomes did not differ between the intervention and control groups. The findings should be interpreted with caution due to the small number of included trials and low certainty of evidence. PROSPERO REGISTRATION NUMBER: CRD42024496276.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.