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Article

Can Nebulised Colistin Therapy Improve Outcomes in Critically Ill Children with Multi-Drug Resistant Gram-Negative Bacterial Pneumonia?

1
Department of Pediatric Intensive Care Unit, Istanbul University Cerrahpasa Medical Faculty, 34098 Fatih, Istanbul, Turkey
2
Department of Infectious Disease, Istanbul University Cerrahpasa Medical Faculty, 34098 Fatih, Istanbul, Turkey
*
Author to whom correspondence should be addressed.
Received: 6 February 2019 / Revised: 6 April 2019 / Accepted: 9 April 2019 / Published: 11 April 2019
(This article belongs to the Special Issue Antimicrobial Resistance in Gram-negative Bacteria)
In the past decade, multidrug-resistant (MDR) gram-negative bacteria have become a major problem, especially for patients in intensive care units. Recently, colistin became the last resort therapy for MDR gram-negative bacteria infections. However, nebulised colistin use was limited to adult patients. Thus, we investigated the efficacy and safety of nebulised colistin treatment against MDR microorganisms in the paediatric intensive care unit (PICU). Data of all patients admitted for various critical illnesses (January 2016 to January 2019) were reviewed. Differences between groups (with and without a history of nebulised colistin) were compared. Of 330 patients, 23 (6.97%) used nebulised colistin. Significant relationships were found between nebulised colistin usage and several prognostic factors (inotropic drug use (p = 0.009), non-invasive mechanical ventilation (p ≤ 0.001), duration in PICU (p ≤ 0.001), and C-reactive protein level (p = 0.003)). The most common microorganism in tracheal aspirate and sputum cultures was Pseudomonas aeruginosa (13 patients). The most common underlying diagnosis was cystic fibrosis, noted in 6 patients. No serious nephrotoxicity and neurotoxicity occurred. This study showed that colistin can be safely used directly in the airway of critically ill children. However, nebulised colistin use did not have a positive effect on mortality and prognosis. View Full-Text
Keywords: colistin; nebulised; multiple drug resistance; pneumonia; Pseudomonas colistin; nebulised; multiple drug resistance; pneumonia; Pseudomonas
MDPI and ACS Style

Aygun, F.; Aygun, F.D.; Varol, F.; Durak, C.; Cokugraş, H.; Camcioglu, Y.; Cam, H. Can Nebulised Colistin Therapy Improve Outcomes in Critically Ill Children with Multi-Drug Resistant Gram-Negative Bacterial Pneumonia? Antibiotics 2019, 8, 40. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics8020040

AMA Style

Aygun F, Aygun FD, Varol F, Durak C, Cokugraş H, Camcioglu Y, Cam H. Can Nebulised Colistin Therapy Improve Outcomes in Critically Ill Children with Multi-Drug Resistant Gram-Negative Bacterial Pneumonia? Antibiotics. 2019; 8(2):40. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics8020040

Chicago/Turabian Style

Aygun, Fatih, Fatma D. Aygun, Fatih Varol, Cansu Durak, Haluk Cokugraş, Yildiz Camcioglu, and Halit Cam. 2019. "Can Nebulised Colistin Therapy Improve Outcomes in Critically Ill Children with Multi-Drug Resistant Gram-Negative Bacterial Pneumonia?" Antibiotics 8, no. 2: 40. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics8020040

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