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Effectiveness of treatment with nebulized colistin in patients with COPD
Nuria Bruguera-Avila1,2,3, Alicia Marin3,4,5, Ignasi Garcia-Olive3,4,5
1Department of Medicine, Hospital Sant Jaume de Calella, Calella, Barcelona, Spain.
Objectives:
To analyze whether the introduction of nebulized colistin in patients with chronic obstructive pulmonary disease (COPD) and infection with Pseudomonas aeruginosa (PA) is associated with a decrease of the number and duration of severe exacerbations.
Materials And Methods:
Thirty six patients with COPD and infection with PA treated with nebulized colistin attending a day hospital during a 5-year (January 2010-December 2014) period were prospectively included. Repeated-measures t-tests were used to assess whether the introduction of colistin was associated with changes in the number of exacerbations or the length of the hospitalizations, comparing for each patient the year prior to the introduction of colistin with the year after.
Results:
After the introduction of colistin, the number of admissions decreased from 2.0 to 0.9 per individual year (P=0.0007), and hospitalizations were shorter (23.3 vs 10.9 days, P=0.00005). These results persisted when patients with and without bronchiectasis or with and without persistence of Pseudomonas were separately analyzed. No pre-post differences were detected in the number of exacerbations not requiring admission.
Conclusion:
Nebulized colistin seems associated with a strong decrease in the number and duration of hospitalizations due to exacerbation in patients with COPD and infection with PA. Clinical trials with a larger number of patients are needed in order to confirm these results.
Insights
Nebulized colistin significantly reduced hospitalizations for patients with chronic obstructive pulmonary disease (COPD) and Pseudomonas aeruginosa (PA) infection. This treatment decreased the number and length of severe exacerbation-related hospital stays.
Area of Science:
- Pulmonary Medicine
- Infectious Diseases
- Pharmacology
Background:
- Chronic obstructive pulmonary disease (COPD) patients with Pseudomonas aeruginosa (PA) infection face severe exacerbations.
- Managing PA infections in COPD is challenging, often leading to frequent hospitalizations.
Purpose of the Study:
- To evaluate the impact of nebulized colistin on severe exacerbations in COPD patients with PA infection.
- To determine if nebulized colistin reduces hospitalization rates and duration.
Main Methods:
- Prospective study of 36 COPD patients with PA infection treated with nebulized colistin over 5 years.
- Repeated-measures t-tests compared exacerbation numbers and hospitalization lengths pre- and post-colistin introduction.
Main Results:
- Nebulized colistin introduction was associated with a significant decrease in annual admissions (2.0 to 0.9, P=0.0007).
- Hospitalization duration also significantly reduced (23.3 to 10.9 days, P=0.00005).
- These benefits were observed across subgroups, including those with and without bronchiectasis or persistent PA.
Conclusions:
- Nebulized colistin appears effective in reducing hospitalizations for COPD patients with PA infection.
- Further clinical trials with larger cohorts are recommended to confirm these findings.