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Published on: January 22, 2021

[Colistin use in ventilator-associated pneumonia due to panresistant Pseudomonas aeruginosa and Acinetobacter

Mehmet Sezai Taşbakan1, Hüsnü Pullukçu, Pervin Korkmaz Ekren

  • 1Ege Universitesi Tip Fakültesi, Göğüs Hastaliklari Anabilim Dali, Izmir. sezai72000@yahoo.com

Mikrobiyoloji Bulteni
|April 2, 2009
PubMed

Insights

Colistin shows promise for treating panresistant Acinetobacter baumannii and Pseudomonas aeruginosa ventilator-associated pneumonia (VAP) in intensive care units (ICUs). This study found colistin to be a safe and effective option with manageable side effects.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Pharmacology

Background:

  • Nosocomial infections caused by multidrug-resistant gram-negative bacteria, particularly Acinetobacter baumannii and Pseudomonas aeruginosa, pose a significant mortality risk in intensive care units (ICUs).
  • Limited therapeutic options exist for panresistant strains, making older antibiotics like colistin a critical consideration.
  • Ventilator-associated pneumonia (VAP) is a common and serious complication in mechanically ventilated patients.

Observation:

  • This study evaluated colistin's efficacy in nine patients with VAP caused by panresistant A. baumannii and P. aeruginosa in a respiratory ICU.
  • Patients had a mean age of 75.8 years, and most had prior exposure to anti-pseudomonal antibiotics.
  • VAP developed late in the course of invasive mechanical ventilation (mean 26.6 days).

Findings:

  • Colistin treatment achieved a microbiological response in 6 out of 9 cases.
  • Adverse events were infrequent, including dermatitis in one patient and nephrotoxicity in one patient.
  • Mortality occurred in 6 cases, with three deaths attributed to persistent panresistant infections and three to other concurrent infections.

Implications:

  • Colistin can be considered a safe and effective therapeutic option for managing VAP caused by panresistant A. baumannii and P. aeruginosa.
  • Early consideration of colistin may be warranted in specific ICU settings with high prevalence of these resistant pathogens.
  • Further research is needed to optimize colistin dosing and minimize potential toxicities in critically ill patients.

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