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Safety in treatment of ventilator-associated pneumonia due to extensive drug-resistant Acinetobacter Baumannii with aerosolized colistin in neonates: A preliminary report
- Source :
- Pediatric Pulmonology. 46:60-66
- Publication Year :
- 2010
- Publisher :
- Wiley, 2010.
-
Abstract
- Summary. Background: Infections caused by extensive drug-resistant Acinetobacter baumannii (XDR-AB) have been increasingly observed and are associated with a high mortality rate. We present our experience using aerosolized colistin for the treatment of ventilator-associated pneumonia (VAP) due to XDR-AB in neonates. Methods: The clinical data of neonates who received aerosolized 4 mg per kg of colistin base twice daily as an adjunctive therapy for VAP caused by XDR-AB between July 2008 and September 2009 were retrospectively reviewed. The outcomes were compared with the neonates with VAP from XDR-AB in October 2006–September 2007 who did not receive aerosolized colistin. Results: During the study period, eight neonates (three preterm and five term neonates) with VAP caused by XDR-AB received aerosolized colistin. All isolated pathogens from the tracheobronchial specimens of the eight patients were XDR-AB susceptible to colistin only. Six patients received aerosolized colistin without concomitant intravenous colistin. All children were cured with eradication of XDR-AB from respiratory secretions. Seven patients survived and were discharged from the hospital, and one died from bacterial sepsis unrelated to the VAP episode. There were no clinical or laboratory adverse events related to aerosolized colistin. Compared to the seven neonates in the earlier period, the neonates who received aerosolized colistin had higher birth weight and gestational age, and lower mortality rate (13% vs. 71%, P ¼ 0.04). Conclusions: Aerosolized colistin may be a useful adjunctive therapy in VAP due to XDR-AB. The use of aerosolized colistin in neonates should be investigated in a
- Subjects :
- Acinetobacter baumannii
Male
Pulmonary and Respiratory Medicine
Pediatrics
medicine.medical_specialty
medicine.drug_class
Antibiotics
Bacteremia
Gestational Age
Internal medicine
Administration, Inhalation
Drug Resistance, Bacterial
polycyclic compounds
medicine
Birth Weight
Humans
Adverse effect
Retrospective Studies
Antibacterial agent
Aerosols
biology
Colistin
business.industry
Infant, Newborn
Ventilator-associated pneumonia
Pneumonia, Ventilator-Associated
biochemical phenomena, metabolism, and nutrition
Thailand
bacterial infections and mycoses
medicine.disease
biology.organism_classification
Anti-Bacterial Agents
Pneumonia
Treatment Outcome
Pediatrics, Perinatology and Child Health
bacteria
Female
lipids (amino acids, peptides, and proteins)
business
Acinetobacter Infections
medicine.drug
Subjects
Details
- ISSN :
- 87556863
- Volume :
- 46
- Database :
- OpenAIRE
- Journal :
- Pediatric Pulmonology
- Accession number :
- edsair.doi.dedup.....aea34527ff2958e1a11984088bfc22dd
- Full Text :
- https://doi.org/10.1002/ppul.21324