Gram-negative pneumonia in patients who are intubated and mechanically ventilated is associated with increased\nmorbidity and mortality as well as higher healthcare costs compared with those who do not have the disease. Intravenous\nantibiotics are currently the standard of care for pneumonia; however, increasing rates of multidrug resistance\nand limited penetration of some classes of antimicrobials into the lungs reduce the effectiveness of this treatment\noption, and current clinical cure rates are variable, while recurrence rates remain high. Inhaled antibiotics may have\nthe potential to improve outcomes in this patient population, but their use is currently restricted by a lack of specifically\nformulated solutions for inhalation and a limited number of devices designed for the nebulization of antibiotics.\nIn this article, we review the challenges clinicians face in the treatment of pneumonia and discuss the characteristics\nthat would constitute an ideal inhaled drug/device combination. We also review inhaled antibiotic options currently\nin development for the treatment of pneumonia in patients who are intubated and mechanically ventilated.
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