Intensive Care Medicine

, Volume 36, Issue 7, pp 1147–1155

Nebulized and intravenous colistin in experimental pneumonia caused by Pseudomonas aeruginosa

Authors

  • Qin Lu
    • Multidisciplinary Intensive Care Unit, Department of Anesthesiology and Critical Care MedicineLa Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, UPMC Univ Paris 06
  • Cassio Girardi
    • Multidisciplinary Intensive Care Unit, Department of Anesthesiology and Critical Care MedicineLa Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, UPMC Univ Paris 06
    • Department of AnesthesiologyFederal University of São Paulo Escola Paulista de Medicina
  • Mao Zhang
    • Multidisciplinary Intensive Care Unit, Department of Anesthesiology and Critical Care MedicineLa Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, UPMC Univ Paris 06
    • Department of Emergency MedicineSchool of Medicine, Second Affiliated Hospital, Zhejiang University
  • Belaïd Bouhemad
    • Multidisciplinary Intensive Care Unit, Department of Anesthesiology and Critical Care MedicineLa Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, UPMC Univ Paris 06
  • Kamel Louchahi
    • Department of PharmacologyAvicenne Hospital, Assistance Publique-Hôpitaux de Paris
  • Olivier Petitjean
    • Department of PharmacologyAvicenne Hospital, Assistance Publique-Hôpitaux de Paris
  • Frédéric Wallet
    • DHURE and INSERM U 416, University School of Medicine
  • Marie-Helene Becquemin
    • Explorations Fonctionelles Respiratoires UPRES 2397, La Pitié-Salpêtrière Hospital
  • Gilles Le Naour
    • Department of PathologyLa Pitié-Salpêtrière Hospital
  • Charles-Hugo Marquette
    • EA4319 University Nice Sophia Antipolis
    • Multidisciplinary Intensive Care Unit, Department of Anesthesiology and Critical Care MedicineLa Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, UPMC Univ Paris 06
    • Réanimation Polyvalente, Département d’Anesthésie-Réanimation Hôpital Pitié-Salpêtrière
Original

DOI: 10.1007/s00134-010-1879-4

Cite this article as:
Lu, Q., Girardi, C., Zhang, M. et al. Intensive Care Med (2010) 36: 1147. doi:10.1007/s00134-010-1879-4

Abstract

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 μg 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 μg g−1 (25–75% interquartile range = 0.8–13.7 μg 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 μg g−1, 25–75% interquartile range = 1.8–16.1 μg g−1) than in lung segments with severe pneumonia (median = 1.2 μg g−1, 25–75% interquartile range = 0.5–3.3 μg g−1) (p < 0.01). After 24 h of treatment, 67% of pulmonary segments had bacterial counts <102 cfu g−1 following nebulization and 28% following intravenous administration (p < 0.001). In control animals, 12% of lung segments had bacterial counts <102 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.

Keywords

AntibioticColistinNebulizationPneumoniaPseudomonas aeruginosaMechanical ventilation

Supplementary material

134_2010_1879_MOESM1_ESM.doc (68 kb)
Supplementary material 1 (DOC 68 kb)

Copyright information

© Copyright jointly held by Springer and ESICM 2010