Inhaled colistin for the treatment of tracheobronchitis and pneumonia in critically ill children without cystic fibrosis

Matthew E Falagas (1) , Georgia Sideri (2) , Ioanna P. Korbila (3) , Evridiki Vouloumanou (3) , John H. Papadatos (2) , Dimitris A. Kafetzis (4)

1 Department of Medicine
2 Pediatric Intensive Care Unit, P. & A. Kyriakou Children's Hospital, Athens, Greece
3 Alfa Institute of Biomedical Sciences (AIBS), Athens, Greece
4 Second Department of Pediatrics, University of Athens, P. & A. Kyriakou Children's Hospital, Athens, Greece

Data regarding the role of inhaled colistin in critically ill pediatric patients without cystic fibrosis are scarce. Three children (1 female), admitted to the intensive care unit (ICU) of a tertiary-care pediatric hospital in Athens, Greece, during 2004-2009 received inhaled colistin as monotherapy for tracheobronchitis (2 children), and as adjunctive therapy for necrotizing pneumonia (1 child). Colistin susceptible Acinetobacter baumannii and Pseudomonas aeruginosa were isolated from the cases' bronchial secretions specimens. All 3 children received inhaled colistin in a dosage of 75mg diluted in 3ml of normal saline twice daily (1.875.000 IU of colistin daily), for a duration of 25, 32, and 15 days respectively. The infections improved in all 3 cases. Also, a gradual reduction, and finally total elimination of the microbial load in bronchial secretions was observed during inhaled colistin treatment in the reported cases. All 3 cases were discharged from the ICU. No bronchoconstriction or any other type of toxicity of colistin was observed. In conclusion, inhaled colistin was effective and safe for the treatment of 2 children with tracheobronchitis, and 1 child with necrotizing pneumonia. Further studies are needed to clarify further the role of inhaled colistin in pediatric critically ill patients without cystic fibrosis.

Mots clés: Medicine

Matthew E Falagas, Georgia Sideri, Ioanna P. Korbila, Evridiki Vouloumanou, John H. Papadatos, et al.. Inhaled colistin for the treatment of tracheobronchitis and pneumonia in critically ill children without cystic fibrosis. Pediatric Pulmonology, 2010, 45 (11), pp.1135. ⟨10.1002/ppul.21302⟩. ⟨hal-00588666⟩