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Pediatric Drugs

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01-08-2015 | Original Research Article

Treatment of Ventilator-Associated Pneumonia Using Intravenous Colistin Alone or in Combination with Inhaled Colistin in Critically Ill Children

Authors: Meltem Polat, Soner Sertan Kara, Anıl Tapısız, Hasan Tezer, Gökhan Kalkan, Anıl Dolgun

Published in: Pediatric Drugs | Issue 4/2015

Abstract

Objective

The objective of this study was to compare the safety and efficacy of inhaled plus intravenous (IV) colistin with that of IV colistin alone in critically ill children with ventilator-associated pneumonia (VAP) due to colistin-only susceptible (COS) Gram-negative bacteria (GNB).

Study Design and Patients

This retrospective cohort study included critically ill children aged 1 month to 18 years with culture-documented monomicrobial VAP due to COS GNB.

Results

Fifty patients were included, and 32 patients received IV colistin alone, whereas 18 patients received inhaled plus IV colistin. No between-cohort differences were observed in clinical (p = 0.49) and microbiological outcomes (p = 0.68), or VAP-related mortality (p = 0.99). Although the bacterial eradication rates did not differ in either treatment group, the median time to bacterial eradication (TBE) was significantly shorter in the inhaled plus IV colistin group than in the IV colistin group. The additional use of inhaled colistin was the only independent factor associated with TBE, and it shortened the median TBE by 3 days. Only one patient in the IV colistin group developed reversible nephrotoxicity. Mild bronchoconstriction was observed in three patients at the time of administration of the first doses of inhaled colistin, which did not require discontinuation of treatment.

Conclusions

The present study has demonstrated that the addition of inhaled colistin to IV colistin led to a shorter TBE in critically ill children with VAP due to COS GNB. However, it did not lead to a significant difference in the clinical and microbiological outcomes of VAP.

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Title: Treatment of Ventilator-Associated Pneumonia Using Intravenous Colistin Alone or in Combination with Inhaled Colistin in Critically Ill Children
Authors: Meltem Polat
Soner Sertan Kara
Anıl Tapısız
Hasan Tezer
Gökhan Kalkan
Anıl Dolgun
Publication date: 01-08-2015
Publisher: Springer International Publishing
Published in: Pediatric Drugs / Issue 4/2015
Print ISSN: 1174-5878
Electronic ISSN: 1179-2019
DOI: https://doi.org/10.1007/s40272-015-0133-5

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Treatment of Ventilator-Associated Pneumonia Using Intravenous Colistin Alone or in Combination with Inhaled Colistin in Critically Ill Children

Abstract

Objective

Study Design and Patients

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objective

Study Design and Patients

Results

Conclusions

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