The INHALE trial: multiple reasons for a negative result.

The INHALE trial, a Bayer-sponsored phase 3 trial in critically ill patients with pneumonia caused by Gram-negative bacteria by Michael Niederman and colleagues,1 did not find aerosolised amikacin as an adjunctive therapy to intravenous antibiotics to be superior to intravenous antibiotics alone. The study design, the doses of amikacin, and the technique of nebulisation are all likely to explain this negative result. [...]