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.