Azithromycin as a Quorum-Sensing Inhibitor for the Prevention of Pseudomonas Aeruginosa Ventilator-Associated Pneumonia

Inclusion Criteria: * Male and non pregnant female aged 18 to 75 years * Patients hospitalized in ICU, under mechanically assisted ventilation expected to be mandatory for 3 days or more * Reasonable survival chance within next few days with an Apache score 10-25 * Tracheal aspirate found positive for P. aeruginosa * The subject (or a close family member in case of incompetence) understands the procedure, agrees to participate, and is willing to give written informed consent * Informed consent must be obtained for all subjects before enrollment in the study, by patient or by a close family member Exclusion Criteria: * Poor prognosis as judged by Apache score II score \>25 * Pregnant female * Grossly under-or overweight (BMI\<18or \>29) * Ongoing therapy with a macrolide * Known allergy to any macrolide * Proven P. aeruginosa pneumonia * Ongoing anti-pseudomonal therapy with a proven susceptible colonizing strain * Anticipated short duration of mechanical ventilation (\<3 days) * Known drug interaction that could either decrease efficacy or raise safety concerns * Severe hepatic failure (type C, score \>10 on Child Pugh scale) * Sick sinus syndrome or long QT syndrome * Recent donation of blood or participation in another clinical trial within 3 months * Any situation exposing the patient to higher risk or possibly confounding results