Studies that evaluated one or more antimicrobials, delivered via the respiratory tract as monotherapy, in patients with pneumonia for at least two days, were eligible for inclusion. Studies which used concurrent inhaled and systemic antimicrobial administration were excluded, except when systemic antimicrobials were not active against the respiratory pathogens.
Colistin was the most frequently assessed antimicrobial administered via the respiratory tract in the included studies. Treatment duration of included studies ranged from two to 36 days. Acinetobacter baumannii, Pseudomonas aeruginosa and Gram-positive cocci were the most commonly isolated pathogens. The majority of included patients had community-acquired pneumonia, or nosocomial pneumonia, including ventilator-associated pneumonia. One-third of included patients received concurrent systemic antimicrobial therapy. The outcomes reported in the review were clinical cure, bacteriological eradication, all-cause mortality, and adverse events.
The authors did not state how the papers were selected for the review, or how many reviewers performed the selection.