Journal of Trauma and Injury · Published 2025-12-31 · DOI 10.20408/jti.2025.0145
Purpose Ventilator-associated pneumonia (VAP) remains a leading cause of morbidity and mortality in intensive care units (ICUs). The effectiveness of prophylactic inhaled amikacin in preventing VAP remains uncertain. This study compared VAP incidence between patients with trauma who received prophylactic inhaled amikacin and those who did not. Methods We conducted a retrospective, single-center analysis of 66 mechanically ventilated trauma patients admitted to the ICU between May and December 2024. Primary outcomes were infection-related ventilator-associated conditions (IVAC) and microbiologically confirmed VAP. Secondary outcomes included mechanical ventilation duration, ICU and hospital length of stay, and 30-day mortality. Statistical analyses comprised chi-square tests, multivariate logistic regression, and Cox proportional hazards regression with propensity score matching. Results A total of 66 patients were included: 28 in the prophylaxis group and 38 in the control group. The prophylaxis group demonstrated a higher unadjusted incidence of IVAC (85.71% vs. 55.26%, P=0.02) and VAP (82.14% vs. 44.74%, P<0.01) compared with the control group. However, after adjustment, logistic regression revealed no significant association between inhaled amikacin and increased risk of VAP (odds ratio [OR], 3.00; 95% confidence interval [CI], 0.80–12.81; P=0.11) or IVAC (OR, 3.10; 95% CI, 0.71–16.43; P=0.15). Similarly, Cox regression analysis showed no significant effect on VAP (hazard ratio [HR], 1.10; 95% CI, 0.47–2.58; P=0.82) or IVAC (HR, 1.68; 95% CI, 0.78–3.59; P=0.18). Secondary outcomes did not differ significantly between groups. Conclusions Prophylactic inhaled amikacin neither prevented nor increased IVAC and VAP risk in mechanically ventilated trauma patients, suggesting no meaningful impact on VAP outcomes in this population.
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