Co-Administration of High-Dose Nebulized Colistin for <i>Acinetobacter baumannii</i> Bacteremic Ventilator-Associated Pneumonia: Impact on Outcomes
<i>Acinetobacter baumannii</i> (<i>A. baumannii</i>) is a difficult-to-treat (DTR) pathogen that causes ventilator-associated pneumonia (VAP) associated with high mortality. To improve the outcome of DTR A. <i>Baumannii</i> VAP, nebulized colistin (NC) was introdu...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-02-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/13/2/169 |
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| author | Ioannis Andrianopoulos Nikolaos Kazakos Nikolaos Lagos Theodora Maniatopoulou Athanasios Papathanasiou Georgios Papathanakos Despoina Koulenti Eleni Toli Konstantina Gartzonika Vasilios Koulouras |
| author_facet | Ioannis Andrianopoulos Nikolaos Kazakos Nikolaos Lagos Theodora Maniatopoulou Athanasios Papathanasiou Georgios Papathanakos Despoina Koulenti Eleni Toli Konstantina Gartzonika Vasilios Koulouras |
| author_sort | Ioannis Andrianopoulos |
| collection | DOAJ |
| description | <i>Acinetobacter baumannii</i> (<i>A. baumannii</i>) is a difficult-to-treat (DTR) pathogen that causes ventilator-associated pneumonia (VAP) associated with high mortality. To improve the outcome of DTR A. <i>Baumannii</i> VAP, nebulized colistin (NC) was introduced with promising but conflicting results on mortality in earlier studies. Currently, NC is used at a much higher daily dose compared to the past. Nevertheless, there is little evidence on the effect of high-dose NC on the outcomes of <i>A</i>. baumannii VAPs, especially in the current era where the percentage of colistin-resistant <i>A</i>. <i>baumannii</i> strains is rising. We conducted a retrospective study comparing bacteremic <i>A. baumannii</i> VAP patients who were treated with and without NC co-administration and were admitted in the Intensive Care Unit of University Hospital of Ioannina from March 2020 to August 2023. Overall, 59 patients (21 and 38 with and without NC coadministration, respectively) were included. Both 28-day and 7-day mortalities were significantly lower in the patient group treated with NC (52.4% vs. 78.9%, <i>p</i> 0.034 and 9.5% vs. 47.4%, <i>p</i> 0.003, respectively). Patients treated with NC had a higher percentage of sepsis resolution by day 7 (38.1% vs. 13.5%, <i>p</i> 0.023) and were more likely to be off vasopressors by day 7 (28.6% vs. 8.1%, <i>p</i> 0.039). The addition of NC in the treatment regime of <i>A</i>. <i>baumannii</i> VAP decreased mortality. |
| first_indexed | 2024-03-07T22:44:36Z |
| format | Article |
| id | doaj.art-709230cdb05942cf8cd86f42d9c39ccd |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-07T22:44:36Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-709230cdb05942cf8cd86f42d9c39ccd2024-02-23T15:05:08ZengMDPI AGAntibiotics2079-63822024-02-0113216910.3390/antibiotics13020169Co-Administration of High-Dose Nebulized Colistin for <i>Acinetobacter baumannii</i> Bacteremic Ventilator-Associated Pneumonia: Impact on OutcomesIoannis Andrianopoulos0Nikolaos Kazakos1Nikolaos Lagos2Theodora Maniatopoulou3Athanasios Papathanasiou4Georgios Papathanakos5Despoina Koulenti6Eleni Toli7Konstantina Gartzonika8Vasilios Koulouras9Intensive Care Unit, University Hospital of Ioannina, 45500 Ioannina, GreeceIntensive Care Unit, University Hospital of Ioannina, 45500 Ioannina, GreeceIntensive Care Unit, University Hospital of Ioannina, 45500 Ioannina, GreeceIntensive Care Unit, University Hospital of Ioannina, 45500 Ioannina, GreeceIntensive Care Unit, University Hospital of Ioannina, 45500 Ioannina, GreeceIntensive Care Unit, University Hospital of Ioannina, 45500 Ioannina, GreeceUQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4029, AustraliaIntensive Care Unit, University Hospital of Ioannina, 45500 Ioannina, GreeceDepartment of Microbiology, University Hospital of Ioannina, 45500 Ioannina, GreeceIntensive Care Unit, University Hospital of Ioannina, 45500 Ioannina, Greece<i>Acinetobacter baumannii</i> (<i>A. baumannii</i>) is a difficult-to-treat (DTR) pathogen that causes ventilator-associated pneumonia (VAP) associated with high mortality. To improve the outcome of DTR A. <i>Baumannii</i> VAP, nebulized colistin (NC) was introduced with promising but conflicting results on mortality in earlier studies. Currently, NC is used at a much higher daily dose compared to the past. Nevertheless, there is little evidence on the effect of high-dose NC on the outcomes of <i>A</i>. baumannii VAPs, especially in the current era where the percentage of colistin-resistant <i>A</i>. <i>baumannii</i> strains is rising. We conducted a retrospective study comparing bacteremic <i>A. baumannii</i> VAP patients who were treated with and without NC co-administration and were admitted in the Intensive Care Unit of University Hospital of Ioannina from March 2020 to August 2023. Overall, 59 patients (21 and 38 with and without NC coadministration, respectively) were included. Both 28-day and 7-day mortalities were significantly lower in the patient group treated with NC (52.4% vs. 78.9%, <i>p</i> 0.034 and 9.5% vs. 47.4%, <i>p</i> 0.003, respectively). Patients treated with NC had a higher percentage of sepsis resolution by day 7 (38.1% vs. 13.5%, <i>p</i> 0.023) and were more likely to be off vasopressors by day 7 (28.6% vs. 8.1%, <i>p</i> 0.039). The addition of NC in the treatment regime of <i>A</i>. <i>baumannii</i> VAP decreased mortality.https://www.mdpi.com/2079-6382/13/2/169<i>Acinetobacter baumannii</i>bacteremiaventilator-associated pneumonianebulized colistinmortalitycritically ill |
| spellingShingle | Ioannis Andrianopoulos Nikolaos Kazakos Nikolaos Lagos Theodora Maniatopoulou Athanasios Papathanasiou Georgios Papathanakos Despoina Koulenti Eleni Toli Konstantina Gartzonika Vasilios Koulouras Co-Administration of High-Dose Nebulized Colistin for <i>Acinetobacter baumannii</i> Bacteremic Ventilator-Associated Pneumonia: Impact on Outcomes Antibiotics <i>Acinetobacter baumannii</i> bacteremia ventilator-associated pneumonia nebulized colistin mortality critically ill |
| title | Co-Administration of High-Dose Nebulized Colistin for <i>Acinetobacter baumannii</i> Bacteremic Ventilator-Associated Pneumonia: Impact on Outcomes |
| title_full | Co-Administration of High-Dose Nebulized Colistin for <i>Acinetobacter baumannii</i> Bacteremic Ventilator-Associated Pneumonia: Impact on Outcomes |
| title_fullStr | Co-Administration of High-Dose Nebulized Colistin for <i>Acinetobacter baumannii</i> Bacteremic Ventilator-Associated Pneumonia: Impact on Outcomes |
| title_full_unstemmed | Co-Administration of High-Dose Nebulized Colistin for <i>Acinetobacter baumannii</i> Bacteremic Ventilator-Associated Pneumonia: Impact on Outcomes |
| title_short | Co-Administration of High-Dose Nebulized Colistin for <i>Acinetobacter baumannii</i> Bacteremic Ventilator-Associated Pneumonia: Impact on Outcomes |
| title_sort | co administration of high dose nebulized colistin for i acinetobacter baumannii i bacteremic ventilator associated pneumonia impact on outcomes |
| topic | <i>Acinetobacter baumannii</i> bacteremia ventilator-associated pneumonia nebulized colistin mortality critically ill |
| url | https://www.mdpi.com/2079-6382/13/2/169 |
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