Document Detail


Nebulized and intravenous colistin in experimental pneumonia caused by Pseudomonas aeruginosa.
MedLine Citation:
PMID:  20397007     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Emergence of multidrug-resistant strains in intensive care units has renewed interest in colistin, which often remains the only available antimicrobial agent active against resistant Pseudomonas aeruginosa. The aim of this study is to compare lung tissue deposition and antibacterial efficiency between nebulized and intravenous administration of colistin in piglets with pneumonia caused by P. aeruginosa. METHODS: In ventilated piglets, colistimethate was administered 24 h following bronchial inoculation of Pseudomonas aeruginosa (minimum inhibitory concentration of colistin = 2 microg ml(-1)) either by nebulization (8 mg kg(-1) every 12 h, n = 6) or by intravenous infusion (3.2 mg kg(-1) every 8 h, n = 6). All piglets were killed 49 h after inoculation. Colistin peak lung tissue concentrations and lung bacterial burden were assessed on multiple post mortem subpleural lung specimens. RESULTS: Median colistin peak lung concentration following nebulization was 2.8 microg g(-1) (25-75% interquartile range = 0.8-13.7 microg g(-1)). Colistin was undetected in lung tissue following intravenous infusion. In the aerosol group, peak lung tissue concentrations were significantly greater in lung segments with mild pneumonia (median = 10.0 microg g(-1), 25-75% interquartile range = 1.8-16.1 microg g(-1)) than in lung segments with severe pneumonia (median = 1.2 microg g(-1), 25-75% interquartile range = 0.5-3.3 microg g(-1)) (p < 0.01). After 24 h of treatment, 67% of pulmonary segments had bacterial counts <10(2) cfu g(-1) following nebulization and 28% following intravenous administration (p < 0.001). In control animals, 12% of lung segments had bacterial counts <10(2) cfu g(-1) 49 h following bronchial inoculation. CONCLUSION: Nebulized colistin provides rapid and efficient bacterial killing in ventilated piglets with inoculation pneumonia caused by Pseudomonas aeruginosa.
Authors:
Qin Lu; Cassio Girardi; Mao Zhang; Belaïd Bouhemad; Kamel Louchahi; Olivier Petitjean; Frédéric Wallet; Marie-Helene Becquemin; Gilles Le Naour; Charles-Hugo Marquette; Jean-Jacques Rouby
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Publication Detail:
Type:  Journal Article     Date:  2010-04-16
Journal Detail:
Title:  Intensive care medicine     Volume:  36     ISSN:  1432-1238     ISO Abbreviation:  Intensive Care Med     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-10     Completed Date:  2010-10-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1147-55     Citation Subset:  IM    
Affiliation:
Multidisciplinary Intensive Care Unit, Department of Anesthesiology and Critical Care Medicine, La Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, UPMC Univ Paris 06, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Administration, Inhalation
Animals
Anti-Bacterial Agents / administration & dosage*,  pharmacokinetics
Colistin / administration & dosage*,  pharmacokinetics
Disease Models, Animal
Drug Resistance, Multiple, Bacterial
Injections, Intravenous
Nebulizers and Vaporizers
Pneumonia, Bacterial / drug therapy*,  metabolism,  microbiology
Pseudomonas Infections / drug therapy*,  metabolism,  microbiology
Pseudomonas aeruginosa / drug effects*
Swine
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 1066-17-7/Colistin
Comments/Corrections
Comment In:
Intensive Care Med. 2010 Oct;36(10):1795; author reply 1796-7   [PMID:  20652684 ]
Intensive Care Med. 2010 Jul;36(7):1110-1   [PMID:  20397005 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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