Trial reportCritical care (London, England)2026
Amikacin pharmacokinetics after nebulization among intubated patients.
Trial report in Critical care (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
- Tracheobronchial exposure should not be equated with parenchymal target attainment for nebulized amikacin.Critical care (London, England) · 2026Article
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16 authors.
Funding
Abstract
backgroundAmikacin nebulization may be used in mechanically ventilated patients for pneumonia prevention and treatment. Available drug delivery and pharmacokinetic knowledge mainly rely on in vitro data and studies of a limited number of patients.
methodsTo evaluate pulmonary and systemic pharmacokinetics of nebulized amikacin in mechanically ventilated patients and assess the influence of ventilation and nebulization conditions on drug concentrations in the tracheal aspirate and plasma, this ancillary study of a published randomized trial performed population pharmacokinetic modelling on 498 tracheal aspirates and 602 plasma concentrations following 20 mg/kg amikacin vibrating mesh nebulization among 261 patients.
resultsTracheal aspirate amikacin concentrations were very high but variable between patients (median peak concentration 7269 µg/g, interquartile range 4935–9846 µg/g). The tracheal aspirate concentration declined with a median terminal half-life of 7.6 h (interquartile range 5.3–44.2 h), and no accumulation was observed over three doses. Systemic absorption was marginal (median peak plasma concentration 1.9 mg/L, interquartile range 1.3-3.0 mg/L). Despite differences in ventilation mode, circuit type, humidification, inspiratory flow rate, respiratory rate, and tidal volume, no significant impact on tracheal aspirate and plasma amikacin concentrations was observed.
conclusionsNebulized amikacin achieved high pulmonary concentrations with minimal systemic exposure. Tracheal aspirate and plasma drug concentration were not significantly influenced by ventilation or nebulization conditions. These findings suggest that strict optimization of nebulization parameters may not be necessary when aiming for tracheobronchial antibiotic inhaled delivery such as to prevent ventilator associated pneumonia.
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