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Original Article
- Infection/Pharmacology
- Clinical Effectiveness and Nephrotoxicity of Aerosolized Colistin Treatment in Multidrug-Resistant Gram-Negative Pneumonia
- Seung Yong Park, Mi Seon Park, Chi Ryang Chung, Ju Sin Kim, Seoung Ju Park, Heung Bum Lee
- Korean J Crit Care Med. 2016;31(3):208-220. Published online August 30, 2016
- DOI: https://doi.org/10.4266/kjccm.2016.00129
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- 3 Crossref
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Abstract
PDF - Background
Colistin (polymyxin E) is active against multidrug-resistant Gram-negative bacteria (MDR-GNB). However, the effectiveness of inhaled colistin is unclear. This study was designed to assess the effectiveness and safety of aerosolized colistin for the treatment of ventilator-associated pneumonia (VAP) caused by MDR-GNB.
Methods
In this retrospective longitudinal study, we evaluated the medical records of 63 patients who received aerosolized colistin treatment for VAP caused by MDR-GNB in the medical intensive care unit (MICU) from February 2012 to March 2014.
Results
A total of 25 patients with VAP caused by MDR-GNB were included in this study. The negative conversion rate was 84.6% after treatment, and acute kidney injury (AKI) occurred in 11 patients (44%, AKI group). The average length of MICU stay and colistin treatment- related factors, such as daily and total cumulative doses and administration period, were not significantly different between groups. In-hospital mortality tended to be higher in the AKI group (p = 0.07). Multivariate analysis showed that a body mass index less than 18 was an independent risk factor of mortality (odds ratio [OR] = 21.95, 95% confidence interval [CI] 1.59-302.23; p = 0.02). Notably, AKI occurrence was closely related to the administration of more than two nephrotoxic drugs combined with aerosolized colistin (OR = 15.03, 95% CI 1.40-161.76; p = 0.025) and septic shock (OR = 8.10, 95% CI 1.40-161.76; p = 0.04).
Conclusions
The use of adjunctive aerosolized colistin treatment appears to be a relatively safe and effective option for the treatment of VAP caused by MDR-GNB. However, more research on the concomitant use of nephrotoxic drugs with aerosolized colistin will be necessary, as this can be an important risk factor of development of AKI. -
Citations
Citations to this article as recorded by
- Co-Administration of High-Dose Nebulized Colistin for Acinetobacter baumannii Bacteremic Ventilator-Associated Pneumonia: Impact on Outcomes
Ioannis Andrianopoulos, Nikolaos Kazakos, Nikolaos Lagos, Theodora Maniatopoulou, Athanasios Papathanasiou, Georgios Papathanakos, Despoina Koulenti, Eleni Toli, Konstantina Gartzonika, Vasilios Koulouras
Antibiotics.2024; 13(2): 169. CrossRef - Aerosolized antibiotics in the treatment of hospital-acquired pneumonia/ventilator-associated pneumonia
Yun Jung Jung, Eun Jin Kim, Young Hwa Choi
The Korean Journal of Internal Medicine.2022; 37(1): 1. CrossRef - Changes in Renal Function by Nebulized Colistimethate Treatment
Hye Jin Ahn, Yoo Jin Jung, Jae Song Kim, Soo Hyun Kim, Eun Sun Son
Korean Journal of Clinical Pharmacy.2017; 27(2): 92. CrossRef
- Co-Administration of High-Dose Nebulized Colistin for Acinetobacter baumannii Bacteremic Ventilator-Associated Pneumonia: Impact on Outcomes
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