Evidence map›Paper›PMID 40617974›Full record

SynthesisLung2025

Prophylactic Inhaled Antibiotics for Ventilator-Associated Pneumonia: A Systematic Review and Meta-Analysis of Incidence and Mortality Outcomes.

Carlos Valladares, Bryan Gregory, Sheilabi Seeburun, Ahmed Dawood Al Mahrizi, Shreya Shambhavi, Adam Kaplan, Wajahat Khan

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Lung, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Carlos ValladaresDepartment of Internal Medicine, Rutgers Health-RWJ Barnabas Health, Community Medical Center, 99 NJ-37, Toms River, NJ, 08755, USA. carlos.valladares90@gmail.com.ORCID http://orcid.org/0000-0001-9176-3510
Bryan GregoryDepartment of Internal Medicine, Rutgers Health-RWJ Barnabas Health, Community Medical Center, 99 NJ-37, Toms River, NJ, 08755, USA.ORCID http://orcid.org/0009-0009-1198-669X
Sheilabi SeeburunDepartment of Internal Medicine, Rutgers Health-RWJ Barnabas Health, Community Medical Center, 99 NJ-37, Toms River, NJ, 08755, USA.ORCID http://orcid.org/0000-0002-7810-813X
Ahmed Dawood Al MahriziDepartment of Internal Medicine, University of Malta Medical School, Msida, Malta.ORCID http://orcid.org/0009-0006-0722-827X
Shreya ShambhaviDepartment of Internal Medicine, Rutgers Health-RWJ Barnabas Health, Community Medical Center, 99 NJ-37, Toms River, NJ, 08755, USA.ORCID http://orcid.org/0009-0003-9775-5919
Adam KaplanDepartment of Internal Medicine, Rutgers Health-RWJ Barnabas Health, Community Medical Center, 99 NJ-37, Toms River, NJ, 08755, USA.ORCID http://orcid.org/0009-0009-3388-1899
Wajahat KhanDepartment of Critical Care Medicine, Rutgers Health-RWJ Barnabas Health, Community Medical Center, Toms River, NJ, 08755, USA.ORCID http://orcid.org/0000-0002-7414-3974

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeVentilator-associated pneumonia (VAP) is a common ICU complication linked to high morbidity and mortality. Inhaled antibiotics may offer targeted prophylaxis, but their effectiveness has shown mixed results. This study aims to further evaluate whether inhaled antibiotics reduce VAP incidence and ICU mortality through a systematic review and meta-analysis of the most updated available evidence.

methodsA systematic review was conducted following PRISMA 2020 guidelines. Multiple databases were searched for studies published up to November 14, 2024. Ten studies including 2876 patients (1485 intervention; 1391 control) met inclusion criteria. A random-effects meta-analysis was performed to estimate pooled risk ratios (RR) for VAP incidence and ICU mortality. Risk of bias was assessed using ROBINS-I and certainty of evidence via GRADE.

resultsInhaled antibiotics significantly reduced the incidence of VAP compared to controls (RR = 0.67; 95% CI: 0.58-0.77; p < 0.001), but showed no significant effect on ICU mortality (RR = 0.92; 95% CI: 0.79-1.06; p = 0.25). Moderate heterogeneity was observed in VAP outcomes (I

conclusionInhaled antibiotics significantly reduce VAP incidence but show no clear mortality benefit. While promising for prevention, their survival impact remains uncertain. Clinical use should consider patient context and microbial patterns for targeted approach. Future research should identify high-risk subgroups, assess long-term outcomes, and evaluate antibiotic resistance.

Indexed as

Anti-Bacterial AgentsAntibiotic ProphylaxisPneumonia, Ventilator-AssociatedAdministration, InhalationHospital MortalityHumansIncidenceIntensive Care UnitsAnti-Bacterial AgentsCritically Ill patientsInhaled antibioticsMechanical ventilationPneumoniaVentilator-associated pneumonia

Identifiers

PMID40617974
PMCPMC12228672

What OpenQuestion holds

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Registered trials

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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.