Inhaled colistin for treatment of pneumonia due to colistin-only-susceptible Acinetobacter baumannii

Hee Kyoung Choi, YoungKeun Kim, Hyo Youl Kim, Young Uh

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Purpose: Colistin is used for the treatment of pneumonia associated with multidrug- resistant Acinetobacter baumannii and Pseudomonas aeruginosa. However, the best route of administration and dosage is not known. We report our experience with aerosolized colistin in twelve patients with pneumonia caused by colistin-only-susceptible (COS) A. baumannii. Materials and Methods: We retrospectively reviewed patients' medical records who were treated with aerosolized colistin for the treatment of pneumonia. Results: Ten patients were treated only with aerosolized colistin inhalation and two patients received a 3-day course intravenous colistin, and then switched to colistin inhalation therapy. The median duration of aerosolized colistin therapy was 17 days (5-31 days). Four patients were treated only with aerosolized colistin, whereas 4 patients received concomitant glycopeptides, and 4 received concomitant levofloxacin or cefoperazone/sulbactam. At the end of the therapy, the clinical response rate and bacteriological clearance rate was 83% and 50%, respectively. Colistin-resistant strains were isolated from 3 patients after aerosolized colistin therapy; however, all of them showed favorable clinical response. The median interval between inhalation therapy and resistance was 7 days (range 5-19 days). Acute kidney injury developed in 3 patients. Two patients experienced Clostridium difficile associated diarrhea. One patient developed fever and skin rash after aerosolized colistin therapy. No patient developed neurotoxicity or bronchospasm. Conclusion: Colistin inhalation therapy is deemed tolerable and safe, and could be beneficial as an adjuctive therapy for the management of pneumonia due to COS A. baumannii. However, the potential development of colistin resistance cannot be overlooked.

Original languageEnglish
Pages (from-to)118-125
Number of pages8
JournalYonsei medical journal
Volume55
Issue number1
DOIs
Publication statusPublished - 2014 Jan 1

Fingerprint

Colistin
Acinetobacter baumannii
Pneumonia
Therapeutics
Respiratory Therapy
Cefoperazone
Sulbactam
Bronchial Spasm
Levofloxacin
Clostridium difficile
Glycopeptides
Exanthema

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

@article{9764b28394834832a76f6fe76f09ba6b,
title = "Inhaled colistin for treatment of pneumonia due to colistin-only-susceptible Acinetobacter baumannii",
abstract = "Purpose: Colistin is used for the treatment of pneumonia associated with multidrug- resistant Acinetobacter baumannii and Pseudomonas aeruginosa. However, the best route of administration and dosage is not known. We report our experience with aerosolized colistin in twelve patients with pneumonia caused by colistin-only-susceptible (COS) A. baumannii. Materials and Methods: We retrospectively reviewed patients' medical records who were treated with aerosolized colistin for the treatment of pneumonia. Results: Ten patients were treated only with aerosolized colistin inhalation and two patients received a 3-day course intravenous colistin, and then switched to colistin inhalation therapy. The median duration of aerosolized colistin therapy was 17 days (5-31 days). Four patients were treated only with aerosolized colistin, whereas 4 patients received concomitant glycopeptides, and 4 received concomitant levofloxacin or cefoperazone/sulbactam. At the end of the therapy, the clinical response rate and bacteriological clearance rate was 83{\%} and 50{\%}, respectively. Colistin-resistant strains were isolated from 3 patients after aerosolized colistin therapy; however, all of them showed favorable clinical response. The median interval between inhalation therapy and resistance was 7 days (range 5-19 days). Acute kidney injury developed in 3 patients. Two patients experienced Clostridium difficile associated diarrhea. One patient developed fever and skin rash after aerosolized colistin therapy. No patient developed neurotoxicity or bronchospasm. Conclusion: Colistin inhalation therapy is deemed tolerable and safe, and could be beneficial as an adjuctive therapy for the management of pneumonia due to COS A. baumannii. However, the potential development of colistin resistance cannot be overlooked.",
author = "Choi, {Hee Kyoung} and YoungKeun Kim and Kim, {Hyo Youl} and Young Uh",
year = "2014",
month = "1",
day = "1",
doi = "10.3349/ymj.2014.55.1.118",
language = "English",
volume = "55",
pages = "118--125",
journal = "Yonsei Medical Journal",
issn = "0513-5796",
publisher = "Yonsei University College of Medicine",
number = "1",

}

Inhaled colistin for treatment of pneumonia due to colistin-only-susceptible Acinetobacter baumannii. / Choi, Hee Kyoung; Kim, YoungKeun; Kim, Hyo Youl; Uh, Young.

In: Yonsei medical journal, Vol. 55, No. 1, 01.01.2014, p. 118-125.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Inhaled colistin for treatment of pneumonia due to colistin-only-susceptible Acinetobacter baumannii

AU - Choi, Hee Kyoung

AU - Kim, YoungKeun

AU - Kim, Hyo Youl

AU - Uh, Young

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Purpose: Colistin is used for the treatment of pneumonia associated with multidrug- resistant Acinetobacter baumannii and Pseudomonas aeruginosa. However, the best route of administration and dosage is not known. We report our experience with aerosolized colistin in twelve patients with pneumonia caused by colistin-only-susceptible (COS) A. baumannii. Materials and Methods: We retrospectively reviewed patients' medical records who were treated with aerosolized colistin for the treatment of pneumonia. Results: Ten patients were treated only with aerosolized colistin inhalation and two patients received a 3-day course intravenous colistin, and then switched to colistin inhalation therapy. The median duration of aerosolized colistin therapy was 17 days (5-31 days). Four patients were treated only with aerosolized colistin, whereas 4 patients received concomitant glycopeptides, and 4 received concomitant levofloxacin or cefoperazone/sulbactam. At the end of the therapy, the clinical response rate and bacteriological clearance rate was 83% and 50%, respectively. Colistin-resistant strains were isolated from 3 patients after aerosolized colistin therapy; however, all of them showed favorable clinical response. The median interval between inhalation therapy and resistance was 7 days (range 5-19 days). Acute kidney injury developed in 3 patients. Two patients experienced Clostridium difficile associated diarrhea. One patient developed fever and skin rash after aerosolized colistin therapy. No patient developed neurotoxicity or bronchospasm. Conclusion: Colistin inhalation therapy is deemed tolerable and safe, and could be beneficial as an adjuctive therapy for the management of pneumonia due to COS A. baumannii. However, the potential development of colistin resistance cannot be overlooked.

AB - Purpose: Colistin is used for the treatment of pneumonia associated with multidrug- resistant Acinetobacter baumannii and Pseudomonas aeruginosa. However, the best route of administration and dosage is not known. We report our experience with aerosolized colistin in twelve patients with pneumonia caused by colistin-only-susceptible (COS) A. baumannii. Materials and Methods: We retrospectively reviewed patients' medical records who were treated with aerosolized colistin for the treatment of pneumonia. Results: Ten patients were treated only with aerosolized colistin inhalation and two patients received a 3-day course intravenous colistin, and then switched to colistin inhalation therapy. The median duration of aerosolized colistin therapy was 17 days (5-31 days). Four patients were treated only with aerosolized colistin, whereas 4 patients received concomitant glycopeptides, and 4 received concomitant levofloxacin or cefoperazone/sulbactam. At the end of the therapy, the clinical response rate and bacteriological clearance rate was 83% and 50%, respectively. Colistin-resistant strains were isolated from 3 patients after aerosolized colistin therapy; however, all of them showed favorable clinical response. The median interval between inhalation therapy and resistance was 7 days (range 5-19 days). Acute kidney injury developed in 3 patients. Two patients experienced Clostridium difficile associated diarrhea. One patient developed fever and skin rash after aerosolized colistin therapy. No patient developed neurotoxicity or bronchospasm. Conclusion: Colistin inhalation therapy is deemed tolerable and safe, and could be beneficial as an adjuctive therapy for the management of pneumonia due to COS A. baumannii. However, the potential development of colistin resistance cannot be overlooked.

UR - http://www.scopus.com/inward/record.url?scp=84890625005&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84890625005&partnerID=8YFLogxK

U2 - 10.3349/ymj.2014.55.1.118

DO - 10.3349/ymj.2014.55.1.118

M3 - Article

VL - 55

SP - 118

EP - 125

JO - Yonsei Medical Journal

JF - Yonsei Medical Journal

SN - 0513-5796

IS - 1

ER -