K-475. Inhaled Colistin as Monotherapy for Multidrug-Resistant Gram-Negative Nosocomial Pneumonia: A Case Series
Session: Poster Session: (Almost) Everything You Wanted to Know about VAP/HAP
Saturday, October 25, 2008: 12:00 AM
Room: Hall C
Background: Reports of patients with polymyxin-only susceptible gram-negative nosocomial pneumonia treated with inhaled, but without concurrent intravenous, colistin are rare. Methods: Patients admitted in a tertiary 450-bed tertiary care centre during the period 05/01/2005-05/31/2007 and receiving colistin through nebulization, but not systemically, were included in this retrospective case series. Results: Five patients (three with ventilator-associated pneumonia and two with nosocomial pneumonia) received colistin through nebulization without concomitant intravenous colistin. The isolated pathogens were Acinetobacter baumannii (3 cases), Pseudomonas aeruginosa (1 case) and the combination of Klebsiella pneumoniae, A. baumannii and P. aeruginosa (1 case). They were susceptible only to colistin (3 cases) or to colistin and gentamicin (2 cases). Four (80%) out of the five patients were cured, survived and were discharged. One patient died. No colistin-related adverse event was observed. Conclusions: The experience from this case series and other relevant recent reports suggest that treatment of pneumonia due to polymyxin-only susceptible gram-negative bacilli with inhaled colistin (without concurrent systemic administration) deserves further careful investigation.
Argyris Michalopoulos, MD, FCCP1, Eleni Ioannidou, MD1, Ilias Siempos, MD1, Ioanna Korbila, MD1, Matthew Falagas, MD, MSc, DSc1, Petros Rafailidis, MD, MSc, MRCP UK1 and  M. E. Falagas, None., (1)Alfa Institute of Biomedical Sciences (AIBS), Athens, Greece