Inhaled Colistin for the Treatment of Tracheobronchitis and Pneumonia in Critically Ill Children Without Cystic Fibrosis

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 Pediatr Pulmonol 2010, 45 1135-1140 (C) 2010 Wiley Liss Inc