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Inicio Medicina Clínica (English Edition) Long-term treatment with nebulized colistin in oncological patients with recurre...
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Vol. 159. Issue 9.
Pages 432-436 (November 2022)
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Vol. 159. Issue 9.
Pages 432-436 (November 2022)
Brief report
Long-term treatment with nebulized colistin in oncological patients with recurrent respiratory infections
Tratamiento de larga duración con colistina nebulizada en pacientes oncológicos con infecciones respiratorias recurrentes
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Paula Suanzesa, Juan Aguilar-Companya,b,
Corresponding author
juanaguilarcompany@gmail.com

Corresponding author.
, Esther Rodríguez-Gonzálezc, M. Teresa Martín-Gómezd, M. Rosa Gómez-Domingoe, Isabel Ruiz-Campsa
a Infectious Diseases Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain
b Oncology Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain
c Pneumology Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain
d Microbiology Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain
e Pharmacy Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain
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Abstract
Objectives

To assess the efficacy of long-term treatment with nebulized colistin in reducing the number of respiratory infections, emergency consultations and hospitalizations in oncological patients.

Methods

A retrospective, observational, single-centre study including patients with solid or haematologic malignancies, or pulmonary GVHD after HSTC who received treatment with nebulized colistin for at least six-months to prevent recurrent respiratory infections (July 2010 to June 2017).

Results

Twelve patients were included (median age: 54.4, range: 23–85), 7 with solid malignancies and 5 with haematologic malignancies (2 with pulmonary GVHD). Pseudomonas aeruginosa was the most frequent microorganism in sputum cultures (11/12 patients), all strains were susceptible to colistin. There was a statistically significant reduction (p=0.01) in respiratory infections in the six-month period after starting colistin (median: 1, range: 0–4) compared to the six-month period before (median: 4, range: 1–8). There was also a reduction in emergency consultations (precolistin: median: 1.50, range: 0–3; postcolistin: median: 0, range: 0–3) and hospitalizations (precolistin: median: 1.50, range: 0–3; postcolistin: median: 0, range: 0–3) due to respiratory infections. No colistin-resistant strains were identified.

Conclusions

Long-term treatment with nebulized colistin may be useful to reduce the number of exacerbations in oncological patients with recurrent respiratory infections.

Keywords:
Colistin
Recurrent respiratory infections
Inhaled drug therapy
Immunocompromised host
Oncological patients
Resumen
Objetivos

Evaluar la eficacia de un tratamiento prolongado con colistina nebulizada para reducir el número de infecciones respiratorias, consultas en Urgencias y hospitalizaciones en pacientes oncológicos.

Métodos

Estudio retrospectivo, observacional y unicéntrico en pacientes con neoplasias sólidas o hematológicas o EICR pulmonar tras TPH tratados con colistina nebulizada al menos 6 meses para prevenir infecciones respiratorias recurrentes (julio del 2010-junio del 2017).

Resultados

Se incluyó a 12 pacientes (edad mediana 54,4, rango: 23-85), 7 con cáncer sólido y 5 con neoplasias hematológicas (2 con EICR pulmonar). El microorganismo aislado más frecuentemente en esputos fue Pseudomonasaeruginosa (11/12 pacientes); todas las cepas fueron colistina-sensibles. Se evidenciaron una reducción estadísticamente significativa (p = 0,01) de las infecciones respiratorias en los 6 meses tras iniciar colistina (mediana: 1, rango: 0-4) comparado con los 6 meses previos (mediana: 4, rango: 1-8), y una reducción del número de visitas a Urgencias (precolistina: mediana: 1,50, rango: 0-3; postcolistina: mediana: 0, rango: 0-3) y hospitalizaciones (precolistina: mediana: 1,50, rango: 0-3; postcolistina: mediana: 0, rango: 0-3) por infección respiratoria. No se detectaron cepas resistentes a colistina.

Conclusiones

Un tratamiento prolongado con colistina nebulizada puede ser útil para reducir el número de exacerbaciones en pacientes oncológicos con infecciones respiratorias recurrentes.

Palabras clave:
Colistina
Infecciones respiratorias recurrentes
Tratamiento nebulizado
Paciente inmunodeprimido
Paciente oncológico

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