Colistin inhalation monotherapy for ventilator-associated pneumonia of Acinetobacter baumannii in prematurity.
BACKGROUND
Ventilator-associated pneumonia (VAP) caused by Acinetobacter baumannii is increasing. It has a high mortality rate but experience in using inhaled colistin as monotherapy for VAP in children, especially pre-term infants, is limited. This study presents experiences using aerosolized colistin as monotherapy for VAP due to A. baumannii infection in pre-term infants.


METHODS
Eight pre-term infants (gestational age 25-36 weeks) admitted to the neonatal intensive care unit (NICU) of Kaohsiung Chang Gung Memorial Hospital in Taiwan from January 2006 to December 2010 who received inhaled colistin as monotherapy for VAP due to A. baumannii infection were retrospectively evaluated. Of the isolated microorganisms, five were multi-drug resistant strains of A. baumannii (MDR-AB) but all were sensitive to colistin. All patients received inhaled colistin at a dose of 1,000,000 IU (33.4 mg) twice daily for an average of 9.1 days (range, 4-22 days).


RESULTS
All pre-term infants were cured, with A. baumannii eradicated from airway secretions. There were no clinical or laboratory adverse events related to colistin use.


CONCLUSIONS
Aerosolized colistin may be used as monotherapy for VAP due to A. baumannii infection in pre-term infants. A larger controlled study is warranted to corroborate the findings.
Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Chia-Hao
CH
Kang
Chih-Min
CM
Tsai
Tin-Hsin
TH
Wu
Hsin-Yi
HY
Wu
Mei-Yung
MY
Chung
Chih-Cheng
CC
Chen
Yi-Chuan
YC
Huang
Shih-Feng
SF
Liu
Da-Ling
DL
Liao
Chen-Kuang
CK
Niu
Chen-Hsiang
CH
Lee
Hong-Ren
HR
Yu
D000151:Acinetobacter Infections / Q000188:drug therapy* / Q000209:etiology; D040981:Acinetobacter baumannii; D000280:Administration, Inhalation; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D003091:Colistin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology*; D008297:Male; D053717:Pneumonia, Ventilator-Associated / Q000188:drug therapy*; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents; D003091:Colistin
Acinetobacter baumannii; colistin; inhalation; pre-term