Inhaled Amikacin Versus Placebo in Patients With Ventilator-associated Tracheobronchitis

Inclusion criteria: * Age ≥ 18 years * Admission to a participating intensive care unit (ICU) * Invasive mechanical ventilation \> 48 hours * First episode of ventilator-associated tracheobronchitis during the ICU stay defined using the following criteria: (i) purulent tracheobronchial secretions, (iii) no new or progressive persistent pulmonary infiltrate on chest X-ray, and (iv) bacterial growth on endotracheal aspirate ≥10.5 colony-forming unit (CFU)/mL or on bronchoalveolar lavage ≥10.4 CFU/mL or on plugging telescopic catheter ≥10.3 CFU/mL * Coverage by the French health insurance system (Social Security) * Written informed consent obtained from the patient, or, if the patient is not able to give written consent, from his or her legally designated representative (trusted person designated by the patient or, failing that, a family member) or, failing that, inclusion performed by the investigator within the therapeutic window (in such cases, informed consent will be sought by the investigator from the patient, or his or her legally designated representative, whichever is sooner). In all cases, the patient's written informed consent will be obtained as soon as possible. * For woman of childbearing potential: negative pregnancy test result at the time of inclusion Exclusion criteria: * Previous ventilator-associated pneumonia due to the pathogens responsible for ventilator-associated tracheobronchitis during the same ICU stay * On-going antimicrobial therapy fpr ventilato…