Tuberc Respir Dis.  2008 Jan;64(1):8-14. 10.4046/trd.2008.64.1.8.

Effects of Aerosol Colistin Treatment of Pneumonia Caused by Multi-drug Resistant Acinetobacter baumannii

Affiliations
  • 1Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kyung Hee University College of Medicne, Seoul, Korea. mjpwis@chol.com

Abstract

BACKGROUND: Acinetobacter infections are difficult to treat as they often exhibit multiple resistance to the antibiotics that are currently available for the treatment of pneumonia. Colistin is active against gram-negative bacteria, including the multiple drug resistant (MDR) Acinetobacter species. However, intravenous administration of colistin was abandoned because of its nephrotoxicity and neurotoxicity. The aims of this study were to examine the efficacy and safety of colistin administered by aerosol in the treatment of pneumonia caused by MDR Acinetobacter baumannii.
METHODS
We retrospectively reviewed the medical records of patients admitted to the intensive care unit (ICU) from Dec. 2006 to Aug. 2007 who had been diagnosed as suffering from pneumonia due to MDR Acinetobacter baumannii and had been treated with nebulized colistin.
RESULTS
31 patients received aerosolized colistin. The average duration of the treatment was 14+/-7 days and the daily dose of ranged from 225 mg to 300 mg. All patients received concomitant intravenous antimicrobial agents. The average length of the stay in the ICU was 34+/-21 days and in the hospital 58+/-52 days. The overall microbiological eradication was observed in 25 patients (80.6%). 14 of these (56%) were cured, and 11 (44%) were infected with other microorganisms. The overall crude mortality of the ICU was 48%. Nephrotoxicity and significant bronchial constriction did not occur in any patient during neublized colistin treatment.
CONCLUSION
Nebulized colistin may be a safe and effective option in the treatment of pneumonia due to MDR Acinetobacter baumannii. Its role in therapy warrants further investigation in comparative studies.

Keyword

Acinetobacter baumannii; Colistin neubulizer; Pneumonia

MeSH Terms

Acinetobacter
Acinetobacter baumannii
Acinetobacter Infections
Administration, Intravenous
Anti-Bacterial Agents
Anti-Infective Agents
Bronchoconstriction
Colistin
Gram-Negative Bacteria
Humans
Intensive Care Units
Medical Records
Pneumonia
Retrospective Studies
Stress, Psychological
Anti-Bacterial Agents
Anti-Infective Agents
Colistin

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