title: Outcome of ventilator-associated pneumonia due to multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa treated with aerosolized colistin in neonates: a retrospective chart review.
abstract: Multidrug-resistant (MDR) gram-negative bacteria-related nosocomial infections and ventilator-associated pneumonia (VAP) presents an emerging challenge to clinicians. Older antimicrobial agents such as colistin have become life-saving drugs because of the susceptibility of these pathogens. We report our experience with aerosolized colistin in two preterm and one term neonate with Acinetobacter baumannii and Pseudomonas aeruginosa-related VAP who were unresponsiveness to previous antimicrobial treatment. All pathogens were isolated from tracheal aspirate. We used 5 mg/kg (base activity) aerosolized colistin methanesulfonate sodium in every 12 h as an adjunctive therapy for VAP. VAP was treated by 14, 14, and 16-day courses of aerosolized colistin in these patients, respectively. No adverse effect such as nephrotoxicity or neurotoxicity was observed. We found that aerosolized colistin was tolerable and safe, and it may be an adjunctive treatment option for MDR gram-negative bacterial VAP in neonates. Further studies are needed to determine appropriate doses for aerosolized colistin and its eligibility as an alternative treatment choice in newborns.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Neonatal Intensive Care Unit, Zekai Tahir Burak Maternity Teaching Hospital, 06230 Ankara, Turkey. istemihancelik@gmail.com
authors.forename: Istemi Han
authors.initials: IH
authors.lastname: Celik
authors.forename: Serife Suna
authors.initials: SS
authors.lastname: Oguz
authors.forename: Gamze
authors.initials: G
authors.lastname: Demirel
authors.forename: Omer
authors.initials: O
authors.lastname: Erdeve
authors.forename: Ugur
authors.initials: U
authors.lastname: Dilmen
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy* / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000187:drug effects / Q000302:isolation & purification; D000280:Administration, Inhalation; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D003091:Colistin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D053717:Pneumonia, Ventilator-Associated / Q000188:drug therapy* / Q000382:microbiology; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000302:isolation & purification; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; C004691:colistinmethanesulfonic acid; D003091:Colistin