Izvorni znanstveni članak
Inhalation plus intravenous colistin versus intravenous colistin alone for treatment of ventilator associated pneumonia
TAJANA ZAH BOGOVIĆ
; Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Zagreb, Kišpatićeva 12, HR-10000 Zagreb, Croatia
ROBERT BARONICA
; Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Zagreb, Kišpatićeva 12, HR-10000 Zagreb, Croatia
BORIS TOMAŠEVIĆ
; Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Zagreb, Kišpatićeva 12, HR-10000 Zagreb, Croatia
MIRJANA MIRIĆ
; Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Zagreb, Kišpatićeva 12, HR-10000 Zagreb, Croatia
ŽELJKO DRVAR
; Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Zagreb, Kišpatićeva 12, HR-10000 Zagreb, Croatia
MARIO PAVLEK
; Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Zagreb, Kišpatićeva 12, HR-10000 Zagreb, Croatia
VESNA BRATIĆ
; Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Zagreb, Kišpatićeva 12, HR-10000 Zagreb, Croatia
MLADEN PERIĆ
; Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Zagreb, Kišpatićeva 12, HR-10000 Zagreb, Croatia
ANA BUDIMIR
; Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, Zagreb, Croatia
ZRINKA BOŠNJAK
; Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, Zagreb, Croatia
PERO HRABAČ
; Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Zagreb, Croatia
Sažetak
In the setting of intensive care units the incidences of multi-drug resistant gram-negative (MDR-GN) pathogens causing
ventilator associated pneumonia (VAP) has increased, leading clinicians to use colistin. Our aim was to assess outcomes
associated with the use of inhalation and intravenous colisitn versus only intravenous colistin in patients with MDR-GN VAP.
A retrospective, single centre study at University Hospital Centre, Zagreb. Patients were divided in two groups, according
to their administration of antibiotics – inhalation and intravenous (INH+IV) administration for 8 patients or intravenous only
(IV) administration for 23 patients.
The results showed that demographic and clinical characteristics and the gram negative pathogens isolated were similar
between the two groups, except for K. pneumoniae, which was higher in the IV group. No statistically significant difference
between the two groups were observed regarding intensive care unit mortality (P=0.951), sepsis (P=0.474), acute
respiratory distress syndrome (P=0.548), length of ICU stay (P=0.686) and length of mechanical ventilation (P=0.858). A
statistically significant difference was found regarding the eradication of pathogens in respiratory cultures (P= 0.018).
The addition of inhalation to intravenous colistin in MDR-GN VAP improves microbiologic outcome, but does not improve
ICU mortality in these patients. Larger prospective trials are warranted to confirm the benefit of adjunctive inhalation colistin
as a MDR-GN VAP therapy in the critically ill.
Ključne riječi
ventilator-associated pneumoni; Acinetobacter baumannii; Pseudomonas aeruginosa; Klebsiella pneumoniae
Hrčak ID:
134148
URI
Datum izdavanja:
1.6.2014.
Posjeta: 1.191 *