title: Inhaled colistin for the treatment of tracheobronchitis and pneumonia in critically ill children without cystic fibrosis.
abstract: Data regarding the role of inhaled colistin in critically ill pediatric patients without cystic fibrosis are scarce. Three children (one female), admitted to the intensive care unit (ICU) of a tertiary-care pediatric hospital in Athens, Greece, during 2004-2009 received inhaled colistin as monotherapy for tracheobronchitis (two children), and as adjunctive therapy for necrotizing pneumonia (one child). Colistin susceptible Acinetobacter baumannii and Pseudomonas aeruginosa were isolated from the cases' bronchial secretions specimens. All three children received inhaled colistin at a dosage of 75 mg diluted in 3 ml of normal saline twice daily (1,875,000 IU of colistin daily), for a duration of 25, 32, and 15 days, respectively. All three children recovered from the infections. Also, a gradual reduction, and finally total elimination of the microbial load in bronchial secretions was observed during inhaled colistin treatment in the reported cases. All three cases were discharged from the ICU. No bronchoconstriction or any other type of toxicity of colistin was observed. In conclusion, inhaled colistin was effective and safe for the treatment of two children with tracheobronchitis, and one child with necrotizing pneumonia. Further studies are needed to clarify further the role of inhaled colistin in pediatric critically ill patients without cystic fibrosis.
authors.affiliation: Alfa Institute of Biomedical Sciences, Athens, Greece. m.falagas@aibs.gr
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Falagas
authors.forename: Georgia
authors.initials: G
authors.lastname: Sideri
authors.forename: Ioanna P
authors.initials: IP
authors.lastname: Korbila
authors.forename: Evridiki K
authors.initials: EK
authors.lastname: Vouloumanou
authors.forename: John H
authors.initials: JH
authors.lastname: Papadatos
authors.forename: Dimitris A
authors.initials: DA
authors.lastname: Kafetzis
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy*; D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000302:isolation & purification; D000280:Administration, Inhalation; D000420:Albuterol / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001991:Bronchitis / Q000150:complications / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003091:Colistin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003422:Critical Care; D016638:Critical Illness; D003550:Cystic Fibrosis / Q000150:complications*; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D009241:Ipratropium / Q000627:therapeutic use; D008297:Male; D018410:Pneumonia, Bacterial / Q000150:complications / Q000188:drug therapy*; D011552:Pseudomonas Infections / Q000188:drug therapy*; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000302:isolation & purification; D014136:Tracheitis / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D001993:Bronchodilator Agents; D009241:Ipratropium; D000420:Albuterol; D003091:Colistin