@article{3130147, title = "Inhaled colistin for the treatment of tracheobronchitis and pneumonia in critically ill children without cystic fibrosis", author = "Falagas, M.E. and Sideri, G. and Korbila, I.P. and Vouloumanou, E.K. and Papadatos, J.H. and Kafetzis, D.A.", journal = "Pediatric Pulmonology", year = "2010", volume = "45", number = "11", pages = "1135-1140", issn = "8755-6863, 1099-0496", doi = "10.1002/ppul.21302", keywords = "antibiotic agent; colistin; gentamicin; ipratropium bromide; meropenem; piperacillin plus tazobactam; salbutamol; vancomycin, Acinetobacter baumannii; Acinetobacter infection; antibiotic therapy; article; bronchus secretion; case report; child; childhood disease; critically ill patient; cystic fibrosis; drug efficacy; drug safety; female; Greece; human; infant; intensive care unit; male; nephrotoxicity; pneumonia; preschool child; priority journal; Pseudomonas aeruginosa; Pseudomonas infection; tracheobronchitis; treatment duration; unspecified side effect, Acinetobacter baumannii; Acinetobacter Infections; Administration, Inhalation; Albuterol; Anti-Bacterial Agents; Bronchitis; Bronchodilator Agents; Case-Control Studies; Child; Child, Preschool; Colistin; Critical Illness; Cystic Fibrosis; Female; Hospitals, Pediatric; Humans; Infant; Intensive Care; Ipratropium; Male; Pneumonia, Bacterial; Pseudomonas aeruginosa; Pseudomonas Infections; Tracheitis; Treatment Outcome", abstract = "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. ©2010 Wiley-Liss, Inc." }