Polymyxin B Plus Aerosolized Colistin vs Polymyxin B Alone in Hospital-acquired Pneumonia ("AEROCOL" Study): A Feasibility Study.

IF 1.5 Q3 CRITICAL CARE MEDICINE Indian Journal of Critical Care Medicine Pub Date : 2024-08-01 Epub Date: 2024-07-31 DOI:10.5005/jp-journals-10071-24767
Supradip Ghosh
{"title":"Polymyxin B Plus Aerosolized Colistin vs Polymyxin B Alone in Hospital-acquired Pneumonia (\"AEROCOL\" Study): A Feasibility Study.","authors":"Supradip Ghosh","doi":"10.5005/jp-journals-10071-24767","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>In hospital-acquired pneumonia (HAP) due to extensively drug resistant gram-negative pathogens, can treatment with high-dose colistin aerosolization using specific aerosol delivery protocol, improve clinical outcome in addition to systemic polymyxin-B?</p><p><strong>Materials and methods: </strong>In a randomized control trial, invasively ventilated adult ICU patients with HAP in whom clinicians decided to start systemic polypeptide antibiotics, were randomized to receive either intravenous polymyxin-B plus high-dose colistin nebulization (5-MIU 8-hourly) using specific protocol or intravenous polymyxin-B alone.</p><p><strong>Results: </strong>The study was closed early after recruiting 60% of planned patients because of slow rate of recruitment (24 patients in over 30 months). Treatment success (Primary outcome) was nonsignificantly higher in intervention group (63.66 vs 30.77%; <i>p</i> = 0.217). There was higher rate of microbiological cure in intervention group (60 vs 9.09%: <i>p</i> = 0.018). Numerically better secondary outcomes including fever-free days, ventilator- or vasopressor free days at day-7, ICU and hospital mortality also did not reach statistical significance. Two episodes of transient hypoxia were seen during aerosol delivery. However, overall incidences of adverse effects were not different between groups.</p><p><strong>Conclusion: </strong>This study could not confirm superiority of high-dose colistin aerosolization plus systemic polymyxin-B strategy over polymyxin-B alone in treating HAP due to extensive drug resistance (XDR) gram-negative pathogens.</p><p><strong>How to cite this article: </strong>Ghosh S. Polymyxin B Plus Aerosolized Colistin vs Polymyxin B Alone in Hospital-acquired Pneumonia (\"AEROCOL\" Study): A Feasibility Study. Indian J Crit Care Med 2024;28(8):792-795.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372667/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Critical Care Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5005/jp-journals-10071-24767","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/31 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: In hospital-acquired pneumonia (HAP) due to extensively drug resistant gram-negative pathogens, can treatment with high-dose colistin aerosolization using specific aerosol delivery protocol, improve clinical outcome in addition to systemic polymyxin-B?

Materials and methods: In a randomized control trial, invasively ventilated adult ICU patients with HAP in whom clinicians decided to start systemic polypeptide antibiotics, were randomized to receive either intravenous polymyxin-B plus high-dose colistin nebulization (5-MIU 8-hourly) using specific protocol or intravenous polymyxin-B alone.

Results: The study was closed early after recruiting 60% of planned patients because of slow rate of recruitment (24 patients in over 30 months). Treatment success (Primary outcome) was nonsignificantly higher in intervention group (63.66 vs 30.77%; p = 0.217). There was higher rate of microbiological cure in intervention group (60 vs 9.09%: p = 0.018). Numerically better secondary outcomes including fever-free days, ventilator- or vasopressor free days at day-7, ICU and hospital mortality also did not reach statistical significance. Two episodes of transient hypoxia were seen during aerosol delivery. However, overall incidences of adverse effects were not different between groups.

Conclusion: This study could not confirm superiority of high-dose colistin aerosolization plus systemic polymyxin-B strategy over polymyxin-B alone in treating HAP due to extensive drug resistance (XDR) gram-negative pathogens.

How to cite this article: Ghosh S. Polymyxin B Plus Aerosolized Colistin vs Polymyxin B Alone in Hospital-acquired Pneumonia ("AEROCOL" Study): A Feasibility Study. Indian J Crit Care Med 2024;28(8):792-795.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
医院获得性肺炎中多粘菌素 B 加气雾化秋水仙碱与单用多粘菌素 B 的对比("AEROCOL "研究):可行性研究。
简介对于由广泛耐药的革兰氏阴性病原体引起的医院获得性肺炎(HAP),除了全身使用多粘菌素-B外,使用特定气溶胶给药方案的高剂量可乐定气溶胶治疗能否改善临床疗效?在一项随机对照试验中,临床医生决定开始全身使用多肽类抗生素的侵入性通气 ICU 成人 HAP 患者被随机分配接受静脉注射多粘菌素-B 加使用特定方案的大剂量可乐定雾化吸入(每 8 小时 5-MIU)或单独静脉注射多粘菌素-B:由于招募速度缓慢(30 多个月内招募了 24 名患者),该研究在招募到 60% 的计划患者后提前结束。干预组的治疗成功率(主要结果)无显著性差异(63.66% 对 30.77%;P = 0.217)。干预组的微生物治愈率更高(60% 对 9.09%:P = 0.018)。无发热天数、第 7 天无呼吸机或血管舒张剂天数、重症监护室和住院死亡率等次要结果的数值差异也未达到统计学意义。气雾给药过程中出现了两次短暂性缺氧。然而,各组的不良反应总发生率并无差异:本研究无法证实大剂量可乐定气雾剂加全身多粘菌素-B策略在治疗由广泛耐药(XDR)革兰氏阴性病原体引起的HAP方面优于单独使用多粘菌素-B:医院获得性肺炎中多粘菌素 B 加气雾化秋水仙碱与单用多粘菌素 B("AEROCOL "研究):可行性研究。Indian J Crit Care Med 2024;28(8):792-795.
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
3.50
自引率
10.00%
发文量
299
期刊介绍: Indian Journal of Critical Care Medicine (ISSN 0972-5229) is specialty periodical published under the auspices of Indian Society of Critical Care Medicine. Journal encourages research, education and dissemination of knowledge in the fields of critical and emergency medicine.
期刊最新文献
Care Beyond Cure: Humanizing the Intensive Care Unit Journey. Clinical Characteristics of Obstetric Patients Admitted in ICU During COVID-19 Pandemic and its Comparison with Pre-COVID Period: A Retrospective Analysis from North India. Communication, Shared Decision-making and Goals of Care in the ICU through Electronic Health Records: A Scoping Review. Comparison of Nebulized Glycopyrronium with a Combination of Salbutamol and Ipratropium on Ventilatory Parameters in Critically Ill Mechanically Ventilated Patients of Chronic Obstructive Pulmonary Disease: An Observational Study. Comparison of Trends of Procalcitonin and Neutrophil to Lymphocyte Ratio in Patients of Sepsis in Intensive Care Unit.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1