Alfa Institute of Biomedical Sciences, Athens, Greece.
Pediatr Pulmonol. 2010 Nov;45(11):1135-40. doi: 10.1002/ppul.21302.
Data regarding the role of inhaled colistin in critically ill pediatric patients without cystic fibrosis are scarce. Three children (one 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 (two children), and as adjunctive therapy for necrotizing pneumonia (one child). Colistin susceptible Acinetobacter baumannii and Pseudomonas aeruginosa were isolated from the cases' bronchial secretions specimens. All three children received inhaled colistin at a dosage of 75 mg diluted in 3 ml of normal saline twice daily (1,875,000 IU of colistin daily), for a duration of 25, 32, and 15 days, respectively. All three children recovered from the infections. 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 three 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 two children with tracheobronchitis, and one child with necrotizing pneumonia. Further studies are needed to clarify further the role of inhaled colistin in pediatric critically ill patients without cystic fibrosis.
关于在无囊性纤维化的危重症儿科患者中使用吸入性黏菌素的作用的数据很少。2004 年至 2009 年期间，希腊雅典一家三级儿科医院的重症监护病房（ICU）收治了 3 名儿童（1 名女性），他们因气管支气管炎（2 名儿童）接受了吸入性黏菌素单药治疗，因坏死性肺炎（1 名儿童）接受了吸入性黏菌素辅助治疗。从这些病例的支气管分泌物标本中分离出对黏菌素敏感的鲍曼不动杆菌和铜绿假单胞菌。这 3 名儿童均以每日 75 毫克的剂量（每日 187.5 万单位黏菌素），每日两次（1,875,000 IU 的黏菌素），用 3 毫升生理盐水稀释，分别接受 25、32 和 15 天的吸入性黏菌素治疗。所有 3 名儿童的感染均得到治愈。此外，在报告的病例中，在接受吸入性黏菌素治疗期间，支气管分泌物中的微生物负荷逐渐减少，最终完全消除。所有 3 例均从 ICU 出院。未观察到黏菌素引起的支气管痉挛或任何其他类型的毒性。总之，吸入性黏菌素对 2 例气管支气管炎患儿和 1 例坏死性肺炎患儿的治疗是有效且安全的。需要进一步研究以进一步阐明吸入性黏菌素在无囊性纤维化的危重症儿科患者中的作用。
